Provider Demographics
NPI:1548557622
Name:NELSON, HALEY B (FNP, NP-C, APRN)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:B
Last Name:NELSON
Suffix:
Gender:F
Credentials:FNP, NP-C, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7353 S 2172 W
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-3248
Mailing Address - Country:US
Mailing Address - Phone:801-703-3257
Mailing Address - Fax:
Practice Address - Street 1:7353 S 2172 W
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-3248
Practice Address - Country:US
Practice Address - Phone:801-703-3257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5896884-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily