JUSTIN ILLUM
Nurse Practitioner - Family
Active
Individual
NPI: 1265174452
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | No | - |
| Nurse Practitioner - Family | 363LF0000X | Yes | 10386297-4405 (UT) |
Frequently Asked Questions
NPI 1265174452 is the National Provider Identifier for JUSTIN ILLUM, a Nurse Practitioner - Family provider located in Midvale, UT. This NPI was enumerated on April 8, 2022.
JUSTIN ILLUM practices at 971 E CREEKHILL LN APT 10, Midvale, UT 84047.
Quick Facts
- NPI
- 1265174452
- Type
- Individual
- Enumerated
- Apr 8, 2022
- Last Updated
- Dec 8, 2024
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