Provider Demographics
NPI:1194084269
Name:JONES, ALLYCE KATIE (PMHNP-BC, APRN)
Entity type:Individual
Prefix:DR
First Name:ALLYCE
Middle Name:KATIE
Last Name:JONES
Suffix:
Gender:F
Credentials:PMHNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 W SOUTH JORDAN PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-9002
Mailing Address - Country:US
Mailing Address - Phone:801-893-9564
Mailing Address - Fax:801-893-9062
Practice Address - Street 1:1309 W SOUTH JORDAN PKWY STE 210
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095
Practice Address - Country:US
Practice Address - Phone:801-893-9564
Practice Address - Fax:801-893-9062
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7935706-4405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health