Individual
MRS. TRACY D. NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN CPNP
Contact information
Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-1000
Mailing address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-1000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
217015-8900
UT
Other
Enumeration date
09/30/2012
Last updated
03/09/2014
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