Provider Demographics
NPI:1902488844
Name:GARFIELD, JOLYNN
Entity Type:Individual
Prefix:MRS
First Name:JOLYNN
Middle Name:
Last Name:GARFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 S 1300 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3617
Mailing Address - Country:US
Mailing Address - Phone:801-832-2200
Mailing Address - Fax:
Practice Address - Street 1:1055 N 300 W STE 401
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3306
Practice Address - Country:US
Practice Address - Phone:801-357-7499
Practice Address - Fax:801-373-5980
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9772467-4405363L00000X
UT390200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner