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Individual

ALEXA VICTORIA NICKEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1200 E 3900 S UNIT G175, SALT LAKE CITY, UT 84124-1300
(801) 268-7405
(801) 268-7435
Mailing address
PO BOX 100253, ATLANTA, GA 30384-0253

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9127639-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
9127639-4405
UT

Other

Enumeration date
05/24/2018
Last updated
01/31/2024
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