Provider Demographics
NPI:1639711971
Name:PIRLET, JESSICA (RCP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:PIRLET
Suffix:
Gender:F
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6671 S REDWOOD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-7488
Mailing Address - Country:US
Mailing Address - Phone:801-266-0399
Mailing Address - Fax:801-266-0421
Practice Address - Street 1:6671 S REDWOOD RD STE 100
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-7488
Practice Address - Country:US
Practice Address - Phone:801-266-0399
Practice Address - Fax:801-266-0421
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5366803-57012278C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedCritical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherDO NOT HAVE ANY