Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Jenna Kanoelani Wong

Individual provider Family Medicine Physician · NPI 1417416785

MS. Jenna Kanoelani Wong is a Family Practice in Provo, Utah. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2019, 7 years ago. Practices with Fauquier Physician Practices LLC, a 43-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
7
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
UT
In the registry since
2019
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Practice location Address checks out

475 W 940 N
Provo, UT 84604-3301
Phone: (801) 357-7940
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 11847623-1204 (UT)

Record details

NPI number1417416785
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 17, 2019
Last updated in NPPESAugust 27, 2020
Certification dateAugust 27, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2019 (7 years in practice)
Group practice Fauquier Physician Practices Llc — 43 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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