Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301105080 | MI |
Y | 2080P0204X | Pediatric Emergency Doctor | 10740262-1205 | UT |
NPI | 1114330685 |
---|---|
Provider Name | Dr. Jennifer Hemberg |
First Address | Salt Lake City, UT 84132-0002 |
Second Address | Salt Lake City, UT 84132-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2014 |
Last Update Date | 20/09/2018 |