Individual
MS. NICHOLE CUDDEBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9660 S 1300 E, SANDY, UT 84094-3762
(801) 727-2056
(770) 701-6675
Mailing address
11820 S STATE ST STE 150, DRAPER, UT 84020-7140
(801) 568-0200
(801) 563-0200
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024168646
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
3094717-4406
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124350137
—
VA
Enumeration date
02/02/2010
Last updated
07/30/2025
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