Provider Demographics
NPI:1245060896
Name:WARHURST, JASON C (FNP)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:C
Last Name:WARHURST
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 W 2380 N
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7328
Mailing Address - Country:US
Mailing Address - Phone:435-862-1904
Mailing Address - Fax:
Practice Address - Street 1:1756 W PARK AVE
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-4701
Practice Address - Country:US
Practice Address - Phone:801-254-0309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10826992-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily