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JUSTIN ILLUM
Family Nurse Practitioner
NPI: 1265174452IndividualAccepts Medicare
Specialties, Licenses & Credentials
Student in an Organized Health Care Education/Training Program
Student in an Organized Health Care Education/Training Program
Code: 390200000X
Family Nurse PractitionerPrimary
Nurse Practitioner — Family
Code: 363LF0000X
10386297-4405(UT)
CMS Specialties
PrimaryNURSE PRACTITIONER
Education
OTHER
Class of 2023
Contact & Hours
- Address
- 971 E CREEKHILL LN APT 10
MIDVALE, UT 84047 - Phone
- (417) 693-3850
Quick Facts
- NPI
- 1265174452
- Entity Type
- Individual
- Gender
- Male
- Medicare
- Accepted
- Specialties
- 2
- Locations
- 1
- Years in Practice
- 3
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