Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB WALLACE, A.P.R.N
Active Sole ProprietorJACOB WALLACE, A.P.R.N is a Family Nurse Practitioner healthcare provider located in LOGAN, Utah. NPI 1639915911 is currently active in the NPPES registry. Verify at CMS.
Family Nurse Practitioner · LOGAN, UT
Registration Details
- NPI Number
- 1639915911
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 5, 2024 (2.0901513632899 yrs)
- Last Updated
- Aug 23, 2024
- Licenses
-
7205712-4405 (UT)7205712-4405 (UT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
630 E 1400 N STE 135LOGAN, UT, 843412549Browse UT providers · Browse ZIP 84341
- Phone
- 4357878146
- Fax
- 4357878149
- Primary Specialty
-
Family Nurse Practitioner
363LF0000X
- Additional Specialty
- Family Nurse Practitioner
Other Family Nurse Practitioner Providers in LOGAN, UT
| Name | Credential | NPI |
|---|---|---|
| JENNIFER H ANDERSON | FNP | 1275547895 |
| GEORGE CHRISTOPHER WOOTTON | F.N.P. | 1730246299 |
| ERIC LEONARD SORENSEN | N.P. | 1497945091 |
| LINDA JONES ROBERTS | APRN | 1770760563 |
| KEISA M LYNCH | — | 1972768539 |
| MARCI KAE BUTTARS | APRN | 1710294004 |
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.