Provider Demographics
NPI:1295231850
Name:ATKINSON, JEFF DAVIES (NP)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:DAVIES
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 E 4500 S STE 220
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-8524
Mailing Address - Country:US
Mailing Address - Phone:801-577-7055
Mailing Address - Fax:888-717-7578
Practice Address - Street 1:348 E 4500 S STE 220
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-8524
Practice Address - Country:US
Practice Address - Phone:801-577-7055
Practice Address - Fax:888-717-7578
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8659617-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily