Individual
SANDRA LOUISE MCNICOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5801 FASHION BLVD STE 175, MURRAY, UT 84107-8115
(801) 314-4544
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 314-4544
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2151388900
UT
Other
Enumeration date
07/20/2006
Last updated
10/16/2007
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