Justin Alan Illum
NPI #1265174452 in Midvale, Utah
Provider Information
- NPI Number
- 1265174452
- Entity Type
- Individual
- Name
- Justin Alan Illum
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Apr 8, 2022
- Last Updated
- Dec 8, 2024
Practice Location
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
| Nurse Practitioner - Family — Family |
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