Abigail Brienn Jacketta, CST
Specialist/Technologist, Other, Surgical Technologist in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1265244792
StatusActive
Last updated in NPPESJan 22, 2025
Details
- NPI
- 1265244792
- Entity type
- Individual (NPI-1)
- Name
- Abigail Brienn Jacketta
- Credential
- CST
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 22, 2025
- Certification date
- Jan 22, 2025
- Last updated
- Jan 22, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246ZS0410X | Specialist/Technologist, Other, Surgical Technologist | 187674 | UT | Yes |
Practice location
65 S Mario Capecchi DrSalt Lake City, UT 84132-0005
Phone 801-581-2352
Mailing address
14181 S Hollow Vista CvHerriman, UT 84096-3957
Phone 801-673-8383
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