Individual
JACE NYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
5405 S 500 E STE 204, OGDEN, UT 84405-7420
(801) 479-0184
(801) 479-5642
Mailing address
PO BOX 741729, ATLANTA, GA 30374-1729
(801) 479-0184
(801) 479-5642
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9022831-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437446168
—
UT
Enumeration date
07/30/2019
Last updated
10/29/2019
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