Provider Demographics
NPI:1174978845
Name:CONLEY, JESSICA MICHELLE (NP)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:MICHELLE
Last Name:CONLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:MICHELLE
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:500 FOOTHILL BLVD
Mailing Address - Street 2:OFFICE 111C
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84148
Mailing Address - Country:US
Mailing Address - Phone:801-582-1565
Mailing Address - Fax:801-584-2518
Practice Address - Street 1:500 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84148
Practice Address - Country:US
Practice Address - Phone:801-582-1565
Practice Address - Fax:801-584-2518
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8282806-3102163W00000X
UT8282806-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse