Individual
JARED NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
985 LILLYWOOD LN, NORTH SALT LAKE, UT 84054-3054
(801) 915-3989
Mailing address
985 LILLYWOOD LN, NORTH SALT LAKE, UT 84054-3054
(801) 915-3989
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13111589-1206
UT
Other
Enumeration date
07/27/2022
Last updated
11/09/2022
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