Individual
JACQUELYN MARIE FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1055 N 500 W BLDG A, PROVO, UT 84604-3305
(801) 812-5033
(801) 812-5034
Mailing address
1055 N. 500 W. ATTN: CREDENTIALING, PROVO, UT 84604
(801) 354-8225
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12264914-4405
UT
Other
Enumeration date
06/24/2021
Last updated
05/06/2024
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