Provider Demographics
NPI:1972830768
Name:PARKER, JESSICA ALYSE (FNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ALYSE
Last Name:PARKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E 400 N
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-1347
Mailing Address - Country:US
Mailing Address - Phone:801-489-8464
Mailing Address - Fax:801-489-6378
Practice Address - Street 1:5 E 400 N
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-1347
Practice Address - Country:US
Practice Address - Phone:801-489-8464
Practice Address - Fax:801-798-8513
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT58825764405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily