Provider Demographics
NPI:1457093502
Name:GARNER, JESSICA (PMHNP-BC, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:GARNER
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 E HIGHWAY 123
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:UT
Mailing Address - Zip Code:84539-7725
Mailing Address - Country:US
Mailing Address - Phone:435-820-0730
Mailing Address - Fax:
Practice Address - Street 1:331 E HIGHWAY 123
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:UT
Practice Address - Zip Code:84539-7725
Practice Address - Country:US
Practice Address - Phone:435-888-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-10
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9424827-4405363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty