Allen, Jennifer W
Allen, Jennifer W is an individual health care provider with primary practice located at 1400 Foothill Dr Suite 100, Salt Lake City UT 84108-2327. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Allen, Jennifer W can be contacted via phone (801) 664-2722.Contact Information
Primary practice address
1400 Foothill Dr Suite 100
Salt Lake City UT 84108-2327
Phone: (801) 664-2722
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 6738811-1205 | Utah |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M-11240 | Idaho |
Profile Details
| NPI number | 1124001789 |
|---|---|
| LBN Legal business name | Allen, Jennifer W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 28th, 2005 |
| Last updated | Mar 30th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124001789 | NPPES |
| Arizona | Other | 86080015085259C106 | TRIWEST |
| Arizona | MEDICAID | 487406 | TRIWEST |
| Arizona | Other | 86080015085260A076 | TRIWEST |
| Arizona | Other | 080151322 | TRIWEST |
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