Individual
KYLE EARL NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2292 N 1430 E, PROVO, UT 84604
(013) 105-4378
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
(435) 251-1000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12425915-1204
UT
207P00000X
Emergency Medicine Physician
R7547
TX
Other
Enumeration date
05/01/2015
Last updated
05/06/2026
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