| Doctor Name: | DR. JEREMY HEWITT |
| NPI Number: | 1104174481 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DNP, APRN, ACNP-BC |
| License Number: | 281822-4405 |
| Business Practice Address: | 9136 S Coppering Ave West Jordan, UT - 840814682 |
| Business Phone Number: | 8016510011 |
| Business Fax Number: | 8012801836 |
| Mailing Address: | 9136 S Coppering Ave, WEST JORDAN |
| State: | UT |
| Postal Code: | 840814682 |
| Phone Number: | 8016510011 |
| Fax Number: | 8012801836 |
| NPI Enumeration Date: | 08/17/2012 |
| NPI Last Update Date: | 12/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 281822-4405 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |