Provider Demographics
NPI:1851705693
Name:DELLOS, JANNETTE YVONNE (NP-C)
Entity Type:Individual
Prefix:
First Name:JANNETTE
Middle Name:YVONNE
Last Name:DELLOS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 E 650 S
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-4478
Mailing Address - Country:US
Mailing Address - Phone:435-503-5292
Mailing Address - Fax:435-315-3614
Practice Address - Street 1:1065 E 650 S
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-4478
Practice Address - Country:US
Practice Address - Phone:435-503-5292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5075746-8900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily