JAN CLEMENTS (NPI# 1124449285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124449285 |
| Entity Type | Individual |
| Full Name | JAN CLEMENTS |
| Credential | APRN |
| Practice Address |
1605 E Shadow Cv Cottonwood Heights UT 84121-3664 |
| Practice Telephone | 4357706594 |
| Practice Fax Number | 8779920810 |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
193894-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
193894-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 1124449285 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 789 Bamberger Dr, Suite B, American Fork, UT 840032181 | 8015997848 |
| Street Address |
1605 E SHADOW CV |
| City | COTTONWOOD HEIGHTS |
| State | UT |
| Zip Code | 84121-3664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902850 | Ivora, Inc. | Nurse Practitioner | 13894 S Bangerter Pkwy Ste 200, Draper, UT 84020-5320 | 2020-11-06 |
| 1104398361 | Lisa Ann Ostrander | Nurse Practitioner | 1385 W 2200 S, Taylorsville, UT 84119-7205 | 2018-12-27 |
| 1336698091 | Marie Jo Borres | Nurse Practitioner | 2211 W 5100 S, Roy, UT 84067-3422 | 2016-09-22 |
| 1013212802 | Your Home Clinic Company | Nurse Practitioner | 1032 Learned Ave, Salt Lake City, UT 84116-3302 | 2011-01-25 |
| 1558484808 | Cynthia Ann Newby | Nurse Practitioner | 451 E Bishop Federal Ln, Salt Lake City, UT 84115-2357 | 2007-04-09 |
| 1487761615 | Trenaisa Nay Consulting, LLC | Nurse Practitioner | 10171 Delsey Cv, South Jordan, UT 84095-7108 | 2006-08-24 |
| 1073533188 | Sandra Louise Mcnicoll | Nurse Practitioner | 5801 Fashion Blvd Ste 175, Murray, UT 84107-8115 | 2006-07-20 |
| 1447222849 | Perrine Johnson Anderson | Nurse Practitioner | 2773 Etienne Way, Sandy, UT 84093-1116 | 2006-02-02 |
| 1083610869 | Caregiver Support Network, Inc | Nurse Practitioner | 310 E 4500 S, Ste 200, Murray, UT 84107-3993 | 2005-06-25 |
| 1194345603 | Kaitlyn Hayes Pelletier | Nurse Practitioner | 2000 Circle of Hope Dr # 1950, Salt Lake City, UT 84112-5550 | 2020-04-24 |
| Find all providers with the same taxonomy | ||||
| City | COTTONWOOD HEIGHTS |
| Zip Code | 84121 |
Please comment or provide details below to improve the information on JAN CLEMENTS.
| 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.