Organization
NUTRIX UTAH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE GOODMAN AGPCNP-BC, PMHNP (PRESIDENT/OWNER)
(801) 425-2831
Entity
Organization
Contact information
Practice address
6621 W WIDE HOLLOW DR, HERRIMAN, UT 84096-3550
(801) 425-2831
Mailing address
6621 W WIDE HOLLOW DR, HERRIMAN, UT 84096-3550
(801) 425-2831
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
11/06/2023
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