Individual
DR. JONATHAN MICHAEL NEILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
12391 S 4000 W, RIVERTON, UT 84096-7012
(801) 302-1700
Mailing address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 965-3600
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9523151-3102
UT
363L00000X
Nurse Practitioner
9523151-4405
UT
363LF0000X
Family Nurse Practitioner
9523151-4405
UT
363LP0200X
Pediatric Nurse Practitioner
Primary
9523151-4405
UT
363LP2300X
Primary Care Nurse Practitioner
9523151-4405
UT
Other
Enumeration date
07/16/2019
Last updated
01/23/2025
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