Coahran, Jackie Russell
Coahran, Jackie Russell is an sole proprietor health care provider with primary practice located at 237 26Th St , Ogden UT 84401-3105. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Coahran, Jackie Russell can be contacted via phone (801) 625-3700.Contact Information
Primary practice address
237 26Th St
Ogden UT 84401-3105
Phone: (801) 625-3700
Fax: (801) 778-6840
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1922294750 |
|---|---|
| LBN Legal business name | Coahran, Jackie Russell |
| Credentials | B.S. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 14th, 2007 |
| Last updated | Sep 14th, 2007 - about 18 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 | 1922294750 | NPPES |
| Utah | MEDICAID | 876000308007 |
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