Individual
MRS. LONDON TERI JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
405 S MAIN ST, SPRINGVILLE, UT 84663-2252
(801) 491-2238
Mailing address
405 S MAIN ST, SPRINGVILLE, UT 84663-2252
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
8735023-4405
UT
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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