Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dallin Douglas Willes

Individual provider Neonatal Nurse Practitioner · NPI 1104307198

Dallin Douglas Willes is a Neonatal Nurse Practitioner in Provo, Utah. Licensed in Utah. Registered with an NPI since 2018.

Licensed in
UT
In the registry since
2018

Practice location Address checks out

1034 N 500 W
Provo, UT 84604-3380
Phone: (801) 357-7707
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neonatal Nurse Practitioner (primary) Taxonomy 363LN0000X · Licence 8281533-4405 (UT)

Record details

NPI number1104307198
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 27, 2018
Last updated in NPPESApril 12, 2022
Certification dateApril 12, 2022
Mailing addressPo Box 27128, Salt Lake City, UT 84127-0128

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