Individual
DANELLE NIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 819-4163
Mailing address
1200 RITTER DR, RIVERDALE, UT 84405-4006
(801) 819-4163
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
6191949-3102
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
6191949-4405
UT
Other
Enumeration date
02/08/2012
Last updated
08/10/2015
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