Katrien Jack, PA-C

Physician Assistant · Roy, UT

Individual Active NPI

NPI number 1366024390

Practice location

1915 W 5950 S
Roy, UT 84067-1454
Phone
(801) 387-8100

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NPI record

NPI
1366024390
Entity type
Individual (Type 1)
Enumeration date
April 28, 2021
Last updated
November 21, 2025
Certified
November 21, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 13028685-1206 UT

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice locations (1)

  • 1351 W 200 N, Kaysville, UT 84037 · (801) 383-3420

About Katrien Jack

Katrien Jack, PA-C is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 1915 W 5950 S, Roy, UT 84067-1454. The NPI number 1366024390 was assigned on April 28, 2021 and the record was last updated on November 21, 2025.

Katrien Jack lists a license in the registry: #13028685-1206 (UT) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Katrien Jack, PA-C?

The NPI number is 1366024390.

What is the phone number of Katrien Jack?

The phone number listed for the practice location is (801) 387-8100.

Where is Katrien Jack located?

1915 W 5950 S, Roy, UT 84067-1454.

What is the taxonomy code for Katrien Jack?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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