Individual
ROBERT LYLE NIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
48 W 1500 N, NEPHI, UT 84648-8900
(435) 623-3000
Mailing address
220 S 200 W, NEPHI, UT 84648-1740
(435) 660-0475
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
7893551-4406
UT
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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