Individual provider · Type 1 NPI

Jamison Lane Creekmore

Medical Physician Assistant · Salt Lake City, UT

NPI number 1871294215 Active

Practice location

1480 N 8000 W
Salt Lake City, UT 84116-3961

Mailing address

36 W Plum St
Grantsville, UT 84029-9652

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X14236708-1206 (UT)

Medical Physician Assistant: Definition to come...

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About NPI 1871294215

Jamison Lane Creekmore's National Provider Identifier is 1871294215, issued on Mar 13, 2023. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Salt Lake City, UT. The record was last updated on Aug 17, 2026.