Provider Demographics
NPI:1578883963
Name:DEARING, GERALD WAYNE (MSN, CFNP)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:WAYNE
Last Name:DEARING
Suffix:
Gender:M
Credentials:MSN, CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2822 W 8750 S
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-9605
Mailing Address - Country:US
Mailing Address - Phone:801-201-8229
Mailing Address - Fax:801-561-7477
Practice Address - Street 1:2822 W 8750 S
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-9605
Practice Address - Country:US
Practice Address - Phone:801-201-8229
Practice Address - Fax:801-561-7477
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT195306-8900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily