Individual
NELSON JACO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4088 US-91, HYDE PARK, UT 84318
(801) 577-4709
Mailing address
4088 US-91, HYDE PARK, UT 84318
(801) 577-4709
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9412327-4405
UT
Other
Enumeration date
12/26/2020
Last updated
02/04/2022
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