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Individual
JAY TODD NILSON
Active
Individual
JAY TODD NILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
366647-1205
UT
207L00000X
Anesthesiology Physician
G-83928
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107008628103
IHC
UT
01
—
190683600
US DEPT OF LABOR
UT
01
—
425650
DESERET MUTUAL
UT
01
—
66104
PEHP
UT
01
—
7151
HEALTHY U
UT
01
—
870666269JTN
EDUCATORS MUTUAL
UT
01
—
PRA02246
MOLINA
UT
01
—
QM0000054865
ALTIUS
UT
Enumeration date
09/16/2006
Last updated
01/27/2021
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