Individual
TIMOTHY JARED BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3742 W 2150 N, LEHI, UT 84048-7801
(385) 220-6257
Mailing address
3288 E WHEAT FIELD LN, EAGLE MOUNTAIN, UT 84005-5527
(801) 636-4913
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8535186-4405
UT
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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