Individual
JACKIE BRINGHURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
318 WEST 700 SOUTH, #62, MONA, UT 84645-8464
(801) 367-9585
Mailing address
PO BOX 62, MONA, UT 84645-0062
(801) 367-9585
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
348575-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
348575-4405
UT
Other
Enumeration date
06/21/2021
Last updated
02/08/2022
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