Nina G Jorgensen, M.D.
Individual provider Active NPI Pediatrics Physician · North Logan, UT
NPI 1013973031 · NPPES record last updated Aug 9, 2007
Key facts
- NPI
- 1013973031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 277163-1205 (UT)
- Practice address
- 2380 N 400 E
Ste C
North Logan, UT 84341-1749 - Phone
- (435) 753-7337
- Fax
- (435) 750-6779
- NPI assigned
- Apr 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277163-1205 | UT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of Pediatrics University of Utah | Pediatrics | Past | Accepting new patients |
| Primary Care Pediatrics | Pediatrics | Past | Accepting new patients |
| Remack LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 277163-1205 | UT | Yes |
Addresses
Primary practice location
2380 N 400 E
Ste C
North Logan, UT 84341-1749
Mailing address
2380 N 400 E
Ste C
North Logan, UT 84341-1749
Phone (435) 753-7337
Other providers in North Logan, UT
- Suezan L Johnson
- Jon W Ahlstrom MD PC
- James Lewis Jones Jr.
- Pauline Margaret Jonsson
- Gina Gasser Jordan
- Barrett Paul Labrum
- Lifetech Consulting
- Logan Medical Group LLC
- Logan Oral Surgery
- Low T Clinic, LLC
All providers in North Logan, UT · Pediatrics Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.