Provider Demographics
NPI:1316017627
Name:ALLAN, JOLOLENE (FNP)
Entity Type:Individual
Prefix:
First Name:JOLOLENE
Middle Name:
Last Name:ALLAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3570 W 9000 S STE 220
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-8873
Mailing Address - Country:US
Mailing Address - Phone:385-645-7474
Mailing Address - Fax:801-930-9073
Practice Address - Street 1:3570 W 9000 S STE 220
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-8873
Practice Address - Country:US
Practice Address - Phone:385-645-7474
Practice Address - Fax:801-930-9073
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2119724405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily