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NPI Code Detail

MEDICARE: HANNAH CLOVER NEILSON

MEDICARE: HANNAH CLOVER NEILSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225800000XRecreation Therapist138106904003UT

General Provider Information

NPI Number : 1841046588
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH CLOVER NEILSON
Provider Business Mailing Address
First Line : 1645 S 1050 W
Second Line :
City : VERNAL
State : UT
Zip : 84078-4635
Country : US
Telephone Number : 801-884-9475
Fax Number :
Provider Business Practice Location Address
First Line : 1480 N 400 E
Second Line :
City : LOGAN
State : UT
Zip : 84341-7525
Country : US
Telephone Number : 435-750-5501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2024
Last Update Date : 04/24/2024

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Directions to “ HANNAH CLOVER NEILSON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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