Healthcare Provider Details

I. General information

NPI: 1245842962
Provider Name (Legal Business Name): EVE O'PRAY-NICHOLS RN, BSN, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 08/24/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6932 E 1400 S
FT. DUCHESNE UT
84026
US

IV. Provider business mailing address

PO BOX 160
FORT DUCHESNE UT
84026-0160
US

V. Phone/Fax

Practice location:
  • Phone: 435-722-5122
  • Fax: 435-725-6845
Mailing address:
  • Phone: 435-722-5122
  • Fax: 435-725-6845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number9047345-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: