Individual
JEFFREY SCOTT WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
542 E 1600 S, BOUNTIFUL, UT 84010-4016
(801) 979-4077
Mailing address
542 E 1600 S, BOUNTIFUL, UT 84010-4016
(801) 979-4077
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
10676959-3102
UT
363LP2300X
Primary Care Nurse Practitioner
Primary
10676959-4405
UT
Other
Enumeration date
06/15/2021
Last updated
08/26/2022
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