MS. Carrie Michelle Jackman, PA-C

NPI #1760602460 in Provo, Utah

Provider Information

NPI Number: 1760602460
Entity Type: Individual
Name: MS. Carrie Michelle Jackman, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Apr 26, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 5314 N 250 W
Address 2: SUITE 220
City: Provo
State: Utah
ZIP Code: 84604-5691
Phone: (801) 225-8484

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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