Individual
JUSTIN NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
910 S 300 W, BLANDING, UT 84511-3921
(435) 678-0700
Mailing address
PO BOX 130, MONTEZUMA CREEK, UT 84534-0130
(435) 678-0700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
12312699-3102
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12312699-4405
UT
Other
Enumeration date
10/06/2022
Last updated
05/27/2026
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