Individual
MARK ROLAND NICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
5305 S 1900 W, ROY, UT 84067-2906
(801) 825-5648
Mailing address
249 S 1050 E, LAYTON, UT 84041-4499
(801) 663-3126
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
6234684-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
6234684-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134769342
—
UT
Enumeration date
01/15/2020
Last updated
05/27/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us