Healthcare Provider Details

I. General information

NPI: 1366389165
Provider Name (Legal Business Name): JOVAN M ROMERO FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

2332 E ALEXANDER LN
ST GEORGE UT
84790-2735
US

IV. Provider business mailing address

2332 E ALEXANDER LN
ST GEORGE UT
84790-2735
US

V. Phone/Fax

Practice location:
  • Phone: 702-563-7210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12485799-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: