Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB CLARK, APRN, PMHNP-BC
DeactivatedJACOB CLARK, APRN, PMHNP-BC is a Psychiatric/Mental Health Nurse Practitioner healthcare provider located in DRAPER, Utah. NPI 1487009957 is deactivated in the NPPES registry. Verify at CMS.
Psychiatric/Mental Health Nurse Practitioner · DRAPER, UT
This NPI has been deactivated.
The record was deactivated on September 20, 2022.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1487009957
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 3, 2016 (6.3835616438356 yrs)
- Last Updated
- Oct 1, 2022
- Deactivated
- Sep 20, 2022
- License
-
8480668-4405 (UT)
Practice Information
- Address
-
138 E 12300 S UNIT 860DRAPER, UT, 840207976Browse UT providers · Browse ZIP 84020
- Phone
- 8014491429
- Primary Specialty
-
Psychiatric/Mental Health Nurse Practitioner
363LP0808X
- Additional Specialty
- Psychiatric/Mental Health Nurse Practitioner
Other Psychiatric/Mental Health Nurse Practitioner Providers in DRAPER, UT
| Name | Credential | NPI |
|---|---|---|
| MR. MICHAEL CHARLES DESJARDINS | MSN, APRN | 1801924766 |
| SHANTEL D DAWE | DNP PMHNP | 1205140951 |
| NATHAN KROEGEL | PMHNP-BC | 1811237514 |
| JAKE HUTCHINGS | — | 1851777403 |
| ERICA ANNE AGLIANO | DNP, APRN, PMHNP-BC | 1932618113 |
| MICHAEL SHELEKHOV | PMHNP-BC | 1235637125 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.