Provider Demographics
NPI:1598374357
Name:ZOBELL, DAVID (AG-ACNP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ZOBELL
Suffix:
Gender:M
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1389 S 325 E
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-5157
Mailing Address - Country:US
Mailing Address - Phone:801-718-9049
Mailing Address - Fax:
Practice Address - Street 1:1389 S 325 E
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-5157
Practice Address - Country:US
Practice Address - Phone:801-718-9049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9822771-8900363LA2100X
UT9822771-4405363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care