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Individual

DR. JEREMY LLEWELLYN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
395 W COUGAR BLVD FL 5, PROVO, UT 84604-3323
(801) 357-4945
Mailing address
1694 MOUNTAIN VIEW DR, SPANISH FORK, UT 84660-2785
(864) 386-7584

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10451854-4405
UT

Other

Enumeration date
09/24/2020
Last updated
09/24/2020
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