Provider Demographics
NPI:1689307647
Name:BORGET, JEANNE MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:BORGET
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10644 N 5660 W
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-9031
Mailing Address - Country:US
Mailing Address - Phone:801-664-7679
Mailing Address - Fax:
Practice Address - Street 1:10644 N 5660 W
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:UT
Practice Address - Zip Code:84003-9031
Practice Address - Country:US
Practice Address - Phone:801-664-7679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT222066-4405207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine