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Mr. JARED BLAKE ALLAN AGACNP

Individual Provider (NPI-1) Active

Nurse Practitioner

Provider Information

NPI Number
1659080927
Provider Type
Individual Provider (NPI-1)
Credentials
AGACNP
Status
Active

Contact & Location

Address
5121 S COTTONWOOD ST, MURRAY, UT, 841075701
Phone
(801) 507-7000

Specialties & Taxonomies

Nurse Practitioner Primary License: UT #9046989-3102
Nurse Practitioner, Acute Care License: UT #9046989-4405

All Addresses

MAILING

PO BOX 27128

SALT LAKE CITY, UT, 841270128

LOCATION

5121 S COTTONWOOD ST

MURRAY, UT, 841075701

(801) 507-7000