JENNICA MARIE VAN BLERKOM (NPI# 1437702875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437702875 |
| Entity Type | Individual |
| Full Name | JENNICA MARIE VAN BLERKOM |
| Practice Address |
4755 S Wallace Ln Holladay UT 84117-6458 |
| Practice Telephone | 9253893863 |
| Mailing Telephone | 9253893863 |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-07-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4755 S WALLACE LN |
| City | HOLLADAY |
| State | UT |
| Zip Code | 84117-6458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063052256 | Abundant Dental Care, P.C. | Dentist | 1548 E 4500 S #104, Holladay, UT 84117 | 2020-01-15 |
| 1578127221 | Signature Utah Dental Partners PC | Clinic/Center | 2240 E Murray Holladay Rd, Holladay, UT 84117 | 2019-04-29 |
| 1700392974 | Marette Monson, LLC | Community/Behavioral Health | 2180 East 4500 South, Suite 105, Holladay City, UT 84117 | 2017-12-23 |
| 1942714639 | Harmon City Inc | Pharmacy | 4675 South Holladay Blvd, Holladay, UT 84117 | 2017-11-17 |
| 1881119444 | Brianna Stewart | Physical Medicine & Rehabilitation | 5151 South 900 East, Suite 100, Salt Lake City, UT 84117 | 2017-08-04 |
| 1861842874 | Whitney Aste | Dentist | 1548 E 4500 S Ste 104, Salt Lake City, UT 84117 | 2016-06-21 |
| 1922403765 | Tri-peak, Pllc | Psychologist | 4535 S 2300 E, Suite B, Salt Lake City, UT 84117 | 2014-10-22 |
| 1356689566 | Mckenzie Vierig | Marriage & Family Therapist | 4568 S Highland Dr Ste 380, Millcreek, UT 84117 | 2013-01-22 |
| 1821348640 | Fabiola Marquez Jamieson | Social Worker | 4500 S 2180 E, Suite 165, Holladay, UT 84117 | 2012-09-19 |
| 1073882882 | Amy Rose White | Social Worker | 4500 South 2180 East, Suite 165, Holladay, UT 84117 | 2011-12-22 |
| Find all providers in zip 84117 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748080 | Shannon Dhungel | Physician Assistant | 82 S 1100 E Ste 402, Salt Lake City, UT 84102-1892 | 2020-04-10 |
| 1124599873 | Tcfh Lc | Physician Assistant | 9777 N 5520 W, Highland, UT 84003-9130 | 2018-12-06 |
| 1528533825 | Ryan Mclean Walsh | Physician Assistant | 1454 University Vlg, Salt Lake City, UT 84108-3518 | 2018-10-12 |
| 1033627351 | Linda Richards Lewis | Physician Assistant | 30 N. 1900 E, Som 5r218, Salt Lake City, UT 84132-0002 | 2018-01-22 |
| 1215446919 | Richard L Mittan | Physician Assistant | 65 E 6850 S, Midvale, UT 84047-1215 | 2017-09-25 |
| 1710416649 | Brian Adams | Physician Assistant | 1308 E 900 S # C, St George, UT 84790-8520 | 2017-06-05 |
| 1972036242 | Jace Meng | Physician Assistant | 30 N 1900 E Rm 5r218, Salt Lake City, UT 84132-0002 | 2017-04-04 |
| 1396289799 | Jefferson M Allen | Physician Assistant | 356 W 840 S, Orem, UT 84058-6778 | 2016-12-05 |
| 1609324151 | Colby Bliss | Physician Assistant | 826 N Paiute Way, Richfield, UT 84701-1849 | 2016-09-13 |
| 1154878692 | Devin Faye Petersen | Physician Assistant | 2995 E Middleton Way, Slc, UT 84124-3055 | 2016-09-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.