Individual provider · Type 1 NPI

Jacob Ryan Heninger, APRN, PMHNP-BC

Psychiatric/Mental Health Nurse Practitioner · Salt Lake City, UT

NPI number 1639017536 Active

Practice location

525 E 100 S Ste 5
Salt Lake City, UT 84102-4210

Call (801) 585-1212 Map

Mailing address

2925 N Church St Unit B302
Layton, UT 84040-6600

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X12298853-4405 (UT)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1639017536

Jacob Ryan Heninger, APRN, PMHNP-BC's National Provider Identifier is 1639017536, issued on Mar 23, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Salt Lake City, UT. The record was last updated on Mar 23, 2026.