Individual
JASON CARLTON STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, APRN, BSN, RN
Contact information
Practice address
1380 E MEDICAL CENTER DR, SAINT GEORGE, UT 84790-2123
(435) 251-2992
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(435) 251-2992
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8301709-4405
UT
363LP2300X
Primary Care Nurse Practitioner
8301709-4405
UT
Other
Enumeration date
10/18/2017
Last updated
04/26/2018
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