Sandra Louise Mcnicoll
Nurse Practitioner - Gerontology
5801 Fashion Blvd Ste 175
Murray
, Utah 84107-8115
Sandra Louise Mcnicoll
Nurse Practitioner - Gerontology
5801 Fashion Blvd Ste 175
Murray
, Utah 84107-8115
(801) 314-4544
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Sandra Louise Mcnicoll
- Po Box 27128
- Salt Lake City, UT
- Zip : 84127-0128
- Phone : (801) 314-4544
Second Address
- Sandra Louise Mcnicoll
- 5801 Fashion Blvd Ste 175
- Murray, UT
- Zip : 84107-8115
- Phone : (801) 314-4544
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 2151388900 | UT |
National Provider Identifier
| NPI | 1073533188 |
|---|---|
| Provider Name | Sandra Louise Mcnicoll |
| First Address | Salt Lake City, UT 84127-0128 |
| Second Address | Murray, UT 84107-8115 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/07/2006 |
| Last Update Date | 16/10/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.