Abigail Brienn Jacketta, CST

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

187674 Issued in UT

Practice address

65 S Mario Capecchi Dr
Salt Lake City, UT 84132-0005

Phone

(801) 581-2352

NPI assigned

Jan 22, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1265244792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14181 S HOLLOW VISTA CV",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840963957",
            "telephone_number": "801-673-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 S MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320005",
            "telephone_number": "801-581-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKETTA",
        "first_name": "ABIGAIL",
        "middle_name": "BRIENN",
        "credential": "CST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "UT",
            "license": "187674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Vijayanand Jabez, M.D.
• Ismahan Jaburi II
• Jared Alton Jaccard, LMT
• Ejay Jack, LCSW
• Heather Jack
• Danielle Marie Jacketta
• Julie Jackman
• Matthew Adrian Jackman
• Megan S Jackman, FNP-BC
• Sherry A Jackman

• Surgical Technologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Surgical Technologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.