Provider Demographics
NPI:1952011306
Name:RENTMEISTER, JORDAN R (DNP/FNP)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:R
Last Name:RENTMEISTER
Suffix:
Gender:M
Credentials:DNP/FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3556 W 5225 S
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-8753
Mailing Address - Country:US
Mailing Address - Phone:801-663-6191
Mailing Address - Fax:
Practice Address - Street 1:3556 W 5225 S
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-8753
Practice Address - Country:US
Practice Address - Phone:801-663-6191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10646913-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily