Individual
MATTHEW RYAN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1974 N 540 E, OREM, UT 84097-2360
(801) 615-1716
Mailing address
1974 N 540 E, OREM, UT 84097-2360
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8350156-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801377767
—
UT
Enumeration date
08/28/2018
Last updated
04/23/2020
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