Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KATRIEN JACK, PA-C
ActiveKATRIEN JACK, PA-C is a Physician Assistant healthcare provider located in ROY, Utah. NPI 1366024390 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · ROY, UT
Registration Details
- NPI Number
- 1366024390
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 28, 2021 (5.2886871838352 yrs)
- Last Updated
- Nov 21, 2025
- License
-
13028685-1206 (UT)
Practice Information
- Address
-
1915 W 5950 SROY, UT, 840671454Browse UT providers · Browse ZIP 84067
- Phone
- 8013878100
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in ROY, UT
| Name | Credential | NPI |
|---|---|---|
| RODNEY K GROGAN | PA-C | 1114915170 |
| JAMES E PARKER | PA-C | 1841270907 |
| RICHARD R RUSSELL | PA | 1184647786 |
| MR. LUCIUS NMN GORDON JR. | PA-C | 1396814778 |
| MR. MICHEAL SHAWN DAWSON | PA-C | 1376853036 |
| VAN J ASTON | PA-C | 1548530140 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.