Nelson Jaco Valid NPI

Individual provider · Nurse Practitioner · Hyde Park, UT

NPI

1457948374

Type

Individual (Type 1)

Primary specialty

Nurse Practitioner

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363L00000X

License number

9412327-4405 (UT)

Sex

Male

Sole proprietor

Yes

Enumerated

2020-12-26

Last updated

2022-02-04