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JACOB WALLACE, A.P.R.N
A.P.R.N
Family Nurse Practitioner
NPI: 1639915911IndividualAccepts Medicare
Specialties, Licenses & Credentials
Gerontology Nurse Practitioner
Nurse Practitioner — Gerontology
Code: 363LG0600X
7205712-4405(UT)
Family Nurse PractitionerPrimary
Nurse Practitioner — Family
Code: 363LF0000X
7205712-4405(UT)
CMS Specialties
PrimaryNURSE PRACTITIONER
Education
OTHER
Class of 2024
Contact & Hours
- Address
- 630 E 1400 N STE 135
LOGAN, UT 84341 - Phone
- (435) 787-8146
Quick Facts
- NPI
- 1639915911
- Entity Type
- Individual
- Gender
- Male
- Medicare
- Accepted
- Specialties
- 2
- Locations
- 1
- Years in Practice
- 2
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