Individual
JENACA WILSON BEAGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1790 N STATE ST, OREM, UT 84057-2025
(801) 224-8255
(801) 224-8301
Mailing address
1790 N STATE ST, OREM, UT 84057-2025
(801) 224-8255
(801) 224-8301
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
4552629-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
4552629-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15856
—
UT
Enumeration date
05/14/2008
Last updated
09/19/2014
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