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General NPI Number Information
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NPI Number | 1104174481
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Entity Type | Individual
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Provider Name | JEREMY HEWITT DNP, APRN, ACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/17/2012
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 9136 S COPPERING AVE
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City | WEST JORDAN
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State | UT
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Zip | 84081-4682
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Country | US
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Telephone | 801-651-0011
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Fax | 801-280-1836
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Provider Business Mailing Address
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Address Line | 9136 S COPPERING AVE
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City | WEST JORDAN
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State | UT
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Zip | 84081-4682
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Country | US
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Telephone | 801-651-0011
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Fax | 801-280-1836
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 281822-4405
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License Number State | UT
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