NPI 1265244792

Abigail Brienn Jacketta, CST

Practitioner Surgical Technologist Salt Lake City, UT

Practice location

Address: 65 S Mario Capecchi Dr, Salt Lake City, UT 84132-0005
Phone: (801) 581-2352
Mailing address: 14181 S Hollow Vista Cv, Herriman, UT 84096-3957

Registered specialties

Surgical Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZS0410X Licence 187674 (UT)

Other Specialist/Technologist, Other providers in Utah →

Registry record

NPI: 1265244792
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Jan 2025
Record last updated: 22 Jan 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.