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Contact Information

JESSICA GRAHAM
4019 W 12600 SOUTH
SUITE #110
RIVERTON, UT84096
 Phone: 801-302-9482
 Fax: 801-302-5532
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Corneal and Contact Management

152WC0802X 41 Optometry
 

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for JESSICA GRAHAM · (Female)

NPI Number 1801989868
Status Active
Credentials
Entity Individual
Enumeration date 10/02/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 No
Identifiers
  • UT License # 5267304-8904
  • UT License # 5267304-9934
  • UT Other 52673049901001 BCBS ID #
  • UT Other 868724 DESERET MUTUAL BENEFIT AD
  • UT Other H870369 0819 GROUP & PENSION ADM.
  • UT Other 84414 PEHP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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