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

Jacob Rex Andersen

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1811799372

Jacob Rex Andersen is a Student in an Organized Health Care Education/Training Program in Glendale, Arizona. Practices as a sole proprietor. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

18701 N 67th Ave
Glendale, AZ 85308-7100
Phone: (623) 561-1000
Show map & directions

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

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1811799372
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 26, 2025
Last updated in NPPESMarch 26, 2025
Certification dateMarch 26, 2025
Mailing address3971 Joshua Ln, Idaho Falls, ID 83401-1778

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