JON GABRIEL MEDINA APRN PMHNP-BC NPI 1649756354

NPI Information

NPI: 1649756354
Provider Name: JON GABRIEL MEDINA, APRN, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
500 FOOTHILL DR
SALT LAKE CITY, UT
ZIP 84148
Phone: (801) 582-1565
Get Directions

Jon Gabriel Medina, APRN, PMHNP-BC is a psychiatric/mental health nurse practitioner in Salt Lake City, UT. Jon Gabriel Medina, APRN, PMHNP-BC NPI is 1649756354. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

500 FOOTHILL DR
SALT LAKE CITY, UT
ZIP 84148-001
Phone: (801) 582-1565

The enumeration date for this NPI number is 7/16/2018 and was last updated on 3/12/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP138067	TEXAS	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	10899873-4405	UTAH	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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