| Vicki L Jackman, APRN | |
|
4624 Holladay Blvd, Salt Lake City, UT 84117-5206 | |
| (801) 277-2682 | |
| (801) 277-2980 |
| Full Name | Vicki L Jackman |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 4624 Holladay Blvd, Salt Lake City, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154376077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 295232-4405 (Utah) | Primary |
| Entity Name | University of Utah Acuity Care Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407250541 PECOS PAC ID: 4789908534 Enrollment ID: O20150127000392 |
| Entity Name | University of Utah Adult Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114321981 PECOS PAC ID: 0941525273 Enrollment ID: O20150209001683 |
| Mailing Address | Practice Location Address |
|---|---|
| Vicki L Jackman, APRN 4624 Holladay Blvd, Salt Lake City, UT 84117-5206 Ph: (801) 277-2682 | Vicki L Jackman, APRN 4624 Holladay Blvd, Salt Lake City, UT 84117-5206 Ph: (801) 277-2682 |
Mrs. Lisa Ann Runyon, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Trauma Services, Salt Lake City, UT 84113 Phone: 801-662-2993 Fax: 801-662-2999 |
Madeline Ann Thayer, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 N Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-3600 |
Ms. Eliza Dansie Parkin, RN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2218 S Dallin St, Salt Lake City, UT 84109 Phone: 801-673-7088 |
Crystal Marshall, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4460 S Highland Dr, Salt Lake City, UT 84124 Phone: 888-949-4864 |
Emma Fong, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3802 S 700 E, Salt Lake City, UT 84106 Phone: 801-264-6000 |
Ashlee Brynn Fenton, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1160 E 3900 S Ste G200, Salt Lake City, UT 84124 Phone: 801-268-7766 |
Ms. Sharon A Korhel, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1105 W 1000 N, Salt Lake City, UT 84116 Phone: 801-408-8626 Fax: 801-364-2436 |