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Individual

JOSHUA NICKELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-4261
(801) 662-4285
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
8053541-3102
UT
363LN0000X
Neonatal Nurse Practitioner
Primary
8053541-4405
UT

Other

Enumeration date
04/26/2022
Last updated
10/25/2022
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