Individual
DR. KENT J NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D.
Contact information
Practice address
3651 WALL AVE, NEWGATE MALL, OGDEN, UT 84405-2014
(801) 612-0202
Mailing address
70 S FAIRFIELD RD STE 10, LAYTON, UT 84041-4495
(801) 294-6200
(801) 497-9301
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
108649-4101
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10864941003001
BLUE CROSS BLUE SHIELD
UT
01
—
10864941004001
BLUE CROSS BLUE SHIELD
UT
01
—
10864941006001
BLUE CROSS BLUE SHIELD
UT
05
—
1689744138
—
UT
01
—
224962
ALTIUS
UT
01
—
80601
PEHP
UT
01
—
PRO7581
MOLINA
UT
Enumeration date
11/09/2006
Last updated
08/04/2009
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