Provider Demographics
NPI:1174009229
Name:NIELSON, FELICIA (HEALTH EDUCATOR)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:NIELSON
Suffix:
Gender:F
Credentials:HEALTH EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 841
Mailing Address - Street 2:
Mailing Address - City:CASTLE DALE
Mailing Address - State:UT
Mailing Address - Zip Code:84513-0841
Mailing Address - Country:US
Mailing Address - Phone:435-609-1850
Mailing Address - Fax:
Practice Address - Street 1:160E 100N
Practice Address - Street 2:
Practice Address - City:CASTLE DALE
Practice Address - State:UT
Practice Address - Zip Code:84513
Practice Address - Country:US
Practice Address - Phone:435-609-6765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator