Most Relevant Information
Provider Data
| NPI Number: | 1003478801 |
| Provider Name: | JENNIFER C GREEN MSN, APRN, NP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 4739191-4405 |
Most Important Dates
| Enumeration Date: | 07/01/2019 |
| Last Updated: | 07/01/2019 |
Provider Practice Location
838 E 625 S
LAYTON
UT
840414300
Practice Location Phone/Fax
| Phone: | 8017255595 |
| Fax: |
Provider Mailing Location
838 E 625 S
LAYTON
UT
840414300
Provider Mailing Phone/Fax
| Phone: | 8017255595 |
| Fax: |