Healthcare Provider Details

I. General information

NPI: 1134979016
Provider Name (Legal Business Name): NICOLE STINGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 W LEGACY DR
FRANKLIN ID
83237-5140
US

IV. Provider business mailing address

24 W LEGACY DR
FRANKLIN ID
83237-5140
US

V. Phone/Fax

Practice location:
  • Phone: 435-770-5901
  • Fax:
Mailing address:
  • Phone: 435-770-5901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9015162-4405
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number54943
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: