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Individual

JOHNATHON IVAR PEDERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
230 S MAIN ST, BOUNTIFUL, UT 84010-6236
(801) 698-0544
Mailing address
230 S MAIN ST, BOUNTIFUL, UT 84010-6236
(801) 698-0544

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10222638-4405
UT

Other

Enumeration date
12/05/2024
Last updated
03/16/2025
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