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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. HEATHER KAYE JACKSON

Active Sole Proprietor

MRS. HEATHER KAYE JACKSON is a Behavioral Health, Residential healthcare provider located in PROVO, Utah. NPI 1720863764 is currently active in the NPPES registry. Verify at CMS.

Behavioral Health, Residential · PROVO, UT

Registration Details

NPI Number
1720863764
Provider Type
Individual
Gender
Female
NPI Issued
Aug 29, 2023 (2.9912861681742 yrs)
Last Updated
Aug 29, 2023
License
F23-104260 (UT)
Sole Proprietor
Yes

Practice Information

Address
1200 TOWNE CENTRE BLVD SPC 1142
PROVO, UT, 846012941
Browse UT providers · Browse ZIP 84601
Phone
9726584509
Primary Specialty
Behavioral Health, Residential
251C00000X
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.