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Individual

JACOB RYAN HENINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN, PMHNP-BC

Contact information

Practice address
525 E 100 S STE 5, SALT LAKE CITY, UT 84102-4210
(801) 585-1212
Mailing address
2925 N CHURCH ST UNIT B302, LAYTON, UT 84040-6600

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12298853-4405
UT

Other

Enumeration date
03/23/2026
Last updated
03/23/2026
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