Individual
ALVIN KIRK NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1954 FORT UNION BLVD, STE 114, SALT LAKE CITY, UT 84121-6899
(800) 594-5736
Mailing address
1954 FORT UNION BLVD, STE 114, SALT LAKE CITY, UT 84121-6899
(800) 594-5736
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3319524406
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107011533101
IHC
UT
01
—
16311
HEALTHY U
UT
01
—
190683600
US DEPT OF LABOR
UT
01
—
33195244000001
BCBS
UT
01
—
68308
PEHP
UT
01
—
740685
DESERET MUTUAL
UT
01
—
870666269NIC
EDUCATORS MUTUAL
UT
01
—
PRA07054
MOLINA
UT
01
—
QM0000054865
ALTIUS
UT
Enumeration date
09/16/2006
Last updated
09/06/2022
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