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Audrey Jantzen, M.d. Pllc
Medical Specialty Clinic/Center in Provo, Utah
NPI 1538391339

Audrey Jantzen, M.d. Pllc is a Medical Specialty Clinic/Center based in Provo, UT and is specialized in Medical Specialty. Audrey Jantzen, M.d. Pllc practices in Provo, UT. The NPI Number for Audrey Jantzen, M.d. Pllc is 1538391339 and holds a License No. 66542191205 (Utah).

The current practice location address for Audrey Jantzen, M.d. Pllc is 3685 N 100 E, Provo, UT and can be reached out via phone at 801-229-1954 and via fax at 801-426-6338.

Location: 3685 N 100 E, Provo, UT, 84604-4594
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1538391339
Provider Name
Audrey Jantzen, M.d. Pllc
Credential
Provider Entity Type
Organization
Address
3685 N 100 E, Provo, UT, 84604-4594
Phone Number
801-229-1954
Fax Number
801-426-6338
Provider Enumeration Date
08/13/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3685 N 100 E
City
Provo
State
Utah
Zip
84604-4594
Phone Number
801-229-1954
Fax Number
801-426-6338
person
Provider Business Mailing Address Details
Address
3685 N 100 E
City
Provo
State
Utah
Zip
84604-4594
Phone Number
801-229-1954
Fax Number
801-426-6338
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
66542191205 (Utah)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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