| Jerrica Elizabeth Stoddard, FNP | |
| 5640 S 3500 W, Roy, UT 84067-9158 | |
| (801) 773-2838 | |
| (801) 773-3025 | 
| Full Name | Jerrica Elizabeth Stoddard | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 5640 S 3500 W, Roy, Utah | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1144584228 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | NP-1179A (Idaho) | Secondary | 
| 363LF0000X | Nurse Practitioner - Family | 9098960-4405 (Utah) | Primary | 
| Entity Name | Central Utah Clinic Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 | 
| Entity Name | Ihc Health Services Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Jerrica Elizabeth Stoddard, FNP 1055 N 500 W, Attn: Credentialing, Provo, UT 84604-3305 Ph: (801) 354-8225 | Jerrica Elizabeth Stoddard, FNP 5640 S 3500 W, Roy, UT 84067-9158 Ph: (801) 773-2838 | 
| Mark Roland Nickle, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5305 S 1900 W, Roy, UT 84067 Phone: 801-825-5648 | |
| Mr. Phil H Johnson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3485 W 5200 S, Roy, UT 84067 Phone: 801-475-3900 Fax: 801-475-3901 | |
| Emily Shanafelt, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3485 W 5200 S, Roy, UT 84067 Phone: 801-475-3900 Fax: 801-475-3901 | |
| Sarah Breckinridge Wadhams, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3485 W 5200 S, Roy, UT 84067 Phone: 801-475-3900 Fax: 801-475-3901 | |
| Sandra Lowe Johnson, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4254 S 2450 W, Roy, UT 84067 Phone: 801-388-8086 | |
| Jill Woodring, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3443 W 5600 S, Roy, UT 84067 Phone: 801-773-4840 Fax: 801-525-8151 |