JACOB D ANDERSON, DNP, Family LOGAN, UT

Contact Information

JACOB D ANDERSON, DNP

630 E 1400 N STE 150
LOGAN, UT 84341-2549

Phone: 435-915-4465
Fax: 435-787-8509
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Family	363LF0000X	50	Nurse Practitioner
Occupational Medicine	261QX0100X
Primary Care	261QP2300X
Urgent Care	261QU0200X

Indicates primary specialty

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NPI Profile & details for JACOB D ANDERSON · (Male)

NPI #	`1316329220`
Status	Active
Credentials	DNP
Entity	Individual
Enumeration date	06/26/2015
Last updated	07/08/2020 - About 6 years ago
Sole proprietor ¹	Yes
Identifiers	UT License # 7942683-4405 ID Other 1205300407 NPI ID Other 833011825 STATE
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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