HOLLY JACKSON (NPI# 1083882278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083882278 |
| Entity Type | Individual |
| Full Name | HOLLY JACKSON |
| Practice Address |
2040 Murray Holladay Rd Ste 205 Salt Lake City UT 84117-5197 |
| Mailing Address |
2422 Cobblestone Way Sandy UT 84093-1884 |
| Practice Telephone | 8012740299 |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2008-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 6683403-3101 | UT | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275802 | Holly Marie Jackson | Technician | 448 W Cooper St, Tipton, MO 65081-8217 | 2020-11-04 |
| 1689156721 | Holly Alegro Jackson | Non-emergency Medical Transport (VAN) | 10550 Murat Dr, Saint Louis, MO 63136-4524 | 2018-09-05 |
| 1417351453 | Holly Jean Jackson | Licensed Practical Nurse | 5a Lafayette Avenue, Canandaigua, NY 14424 | 2014-10-20 |
| 1013212711 | Holly Jackson | Social Worker | 511 W 86th Ter, Kansas City, MO 64114-2822 | 2011-01-11 |
| 1548753700 | Holly Jean Jackson | Behavior Technician | 19800 Village Office Ct, Bend, OR 97702-1872 | 2018-06-12 |
| 1922596220 | Holly Suzanne Jackson | Counselor | 1100 Walnut St, Owensboro, KY 42301-2956 | 2018-04-23 |
| 1720575392 | Holly Jackson | Nurse Anesthetist, Certified Registered | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2018-04-18 |
| 1427576511 | Holly M Jackson | Nurse Practitioner | 905 Dixie St, Carrollton, GA 30117-4417 | 2017-09-08 |
| 1427597301 | Holly Jackson | Registered Nurse | 1109 Jones St, Kennett, MO 63857-3824 | 2017-02-13 |
| 1023551223 | Holly V Jackson | Advanced Practice Midwife | 1900 S Tuttle Ave, Sarasota, FL 34239-3114 | 2016-11-21 |
| Street Address |
2040 MURRAY HOLLADAY RD STE 205 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84117-5197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063052256 | Abundant Dental Care, P.C. | Dentist | 1548 E 4500 S #104, Holladay, UT 84117 | 2020-01-15 |
| 1578127221 | Signature Utah Dental Partners PC | Clinic/Center | 2240 E Murray Holladay Rd, Holladay, UT 84117 | 2019-04-29 |
| 1700392974 | Marette Monson, LLC | Community/Behavioral Health | 2180 East 4500 South, Suite 105, Holladay City, UT 84117 | 2017-12-23 |
| 1942714639 | Harmon City Inc | Pharmacy | 4675 South Holladay Blvd, Holladay, UT 84117 | 2017-11-17 |
| 1881119444 | Brianna Stewart | Physical Medicine & Rehabilitation | 5151 South 900 East, Suite 100, Salt Lake City, UT 84117 | 2017-08-04 |
| 1861842874 | Whitney Aste | Dentist | 1548 E 4500 S Ste 104, Salt Lake City, UT 84117 | 2016-06-21 |
| 1922403765 | Tri-peak, Pllc | Psychologist | 4535 S 2300 E, Suite B, Salt Lake City, UT 84117 | 2014-10-22 |
| 1356689566 | Mckenzie Vierig | Marriage & Family Therapist | 4568 S Highland Dr Ste 380, Millcreek, UT 84117 | 2013-01-22 |
| 1821348640 | Fabiola Marquez Jamieson | Social Worker | 4500 S 2180 E, Suite 165, Holladay, UT 84117 | 2012-09-19 |
| 1073882882 | Amy Rose White | Social Worker | 4500 South 2180 East, Suite 165, Holladay, UT 84117 | 2011-12-22 |
| Find all providers in zip 84117 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548881097 | Daysha Alayne Clukey | Licensed Practical Nurse | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-05-06 |
| 1336690106 | Maria Zagal-crosby | Licensed Practical Nurse | 4460 S Highland Dr, Salt Lake City, UT 84124-3543 | 2016-10-17 |
| 1275901134 | Gillean Gauvreau | Licensed Practical Nurse | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2015-09-09 |
| 1386027027 | Karah Hernandez | Licensed Practical Nurse | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2015-06-30 |
| 1003249426 | Lorie Lee Pierce | Licensed Practical Nurse | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2013-08-21 |
| 1184066185 | Steven Beard | Licensed Practical Nurse | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2013-07-19 |
| 1003167248 | Danielle Watson | Licensed Practical Nurse | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2012-09-27 |
| 1538410238 | Nancy Weaver | Licensed Practical Nurse | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2012-09-21 |
| 1124300660 | Amber Gregg | Licensed Practical Nurse | 344 E 100 S, Suite 301, Salt Lake City, UT 84111-1700 | 2011-09-11 |
| 1306124797 | Shawna Domingo | Licensed Practical Nurse | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2011-08-02 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84117 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.