Individual ProviderJacqueline Ann ThamesLicensed Practical NurseNursing Service ProvidersPractice Address2250 N 1700 W, Layton, UT 84041-1140(801) 779-3001PECOS EnrollmentBased on the most recent information from CMS, provider Jacqueline Ann Thames does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 10:46 AM.Profile DetailsProvider ID1417103060Provider TypeIndividualFull NameThames, Jacqueline AnnCredentialLPNGenderFemaleSole ProprietorNoEnumeration Date8/14/2008Last Updated8/14/2008Contact InformationPractice LocationPractice Address2250 N 1700 W, Layton, UT 84041-1140Phone(801) 779-3001Fax(801) 774-6100Mailing LocationMailing AddressPO Box 460, Bountiful, UT 84011-0460Phone(801) 779-3001Fax(801) 774-6100Provider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense4815152-3101UtahProvider IdentifiersIDDescriptionIssuerID870430116009DescriptionMedicaidIssuerUnlistedUtah