Mark Roland Nickle, FNP | |
5305 S 1900 W, Roy, UT 84067-2906 | |
(801) 825-5648 | |
Not Available |
Full Name | Mark Roland Nickle |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 5 Years |
Location | 5305 S 1900 W, Roy, Utah |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134769342 | NPI | - | NPPES |
1134769342 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 6234684-4405 (Utah) | Secondary |
363LF0000X | Nurse Practitioner - Family | 6234684-4405 (Utah) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Logan Regional Hospital | Logan, UT | Hospital |
Mckay Dee Hospital | Ogden, UT | Hospital |
Brigham City Community Hospital | Brigham city, UT | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Utah Kidney Clinic Llc | 7719306091 | 5 |
Entity Name | Utah Kidney Clinic Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013520154 PECOS PAC ID: 7719306091 Enrollment ID: O20201006002557 |
Mailing Address | Practice Location Address |
---|---|
Mark Roland Nickle, FNP 249 S 1050 E, Layton, UT 84041-4499 Ph: (801) 663-3126 | Mark Roland Nickle, FNP 5305 S 1900 W, Roy, UT 84067-2906 Ph: (801) 825-5648 |
Tiffany Ann Miller, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5305 S 1900 W, Roy, UT 84067 Phone: 801-825-5648 | |
Mrs. Jenelle Marie Jensen, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3443 W 5600 S, Roy, UT 84067 Phone: 801-773-4840 | |
Jerrica Elizabeth Stoddard, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5640 S 3500 W, Roy, UT 84067 Phone: 801-773-2838 Fax: 801-773-3025 | |
Kimberly Ann Greaves, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1915 W 5950 S, Roy, UT 84067 Phone: 801-387-8100 Fax: 801-387-8248 | |
Marie Jo Borres, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2211 W 5100 S, Roy, UT 84067 Phone: 801-884-9154 | |
Mr. Phil H Johnson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3485 W 5200 S, Roy, UT 84067 Phone: 801-475-3900 Fax: 801-475-3901 |