IndividualActive
Holly Jackson
NPI 1083882278 · Licensed Practical Nurse · Salt Lake City, UT
Provider details
- NPI number
- 1083882278
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 6683403-3101 (UT)
Specialties & taxonomies
Nursing Service Providers
Practice location
2040 Murray Holladay Rd Ste 205
Salt Lake City, UT 84117-5197
Phone: (801) 274-0299
Approximate (ZIP-level) locationGet directions
Mailing address
2422 Cobblestone Way
Sandy, UT 84093-1884
Registry dates
- Enumerated
- 2008-02-11
- Last updated
- 2008-02-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.