Individual
MR. JACOB SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1400 N 500 E, LOGAN, UT 84341-2455
(435) 716-2000
Mailing address
573 S 1080 E, SMITHFIELD, UT 84335-5103
(435) 757-3784
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6231344-4405
UT
Other
Enumeration date
07/03/2019
Last updated
10/13/2025
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