Provider Demographics
NPI:1295176410
Name:VREELAND, MICHAEL JON (DNP)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JON
Last Name:VREELAND
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:201-855-2900
Mailing Address - Fax:
Practice Address - Street 1:1159 E 200 N STE 150
Practice Address - Street 2:SUITE 150
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2052
Practice Address - Country:US
Practice Address - Phone:801-855-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6820738-8900363LA2100X
UT6820738-4405363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care