Individual
JENNIFER ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
520 MEDICAL DR, STE #110, BOUNTIFUL, UT 84010-4968
(801) 397-0890
Mailing address
8211 TOP OF THE WORLD DR, SALT LAKE CITY, UT 84121-6031
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
343284-1204
UT
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
343284-1204
UT
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
343284-1204
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D2035
—
UT
Enumeration date
04/06/2006
Last updated
05/28/2010
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