Healthcare Provider Details

I. General information

NPI: 1801594577
Provider Name (Legal Business Name): JULIANNE LANDON DNP-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

965 S 100 W STE 204
LOGAN UT
84321-6072
US

IV. Provider business mailing address

965 S 100 W STE 204
LOGAN UT
84321-6072
US

V. Phone/Fax

Practice location:
  • Phone: 435-213-3797
  • Fax:
Mailing address:
  • Phone: 435-213-3797
  • Fax: 435-213-9581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5358802-4405
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number5358802-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: