Healthcare Provider Details

I. General information

NPI: 1811652258
Provider Name (Legal Business Name): AARON NAKKEN PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 11/03/2021
Certification Date: 11/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

863 N 980 W
OREM UT
84057-7710
US

IV. Provider business mailing address

863 N 980 W
OREM UT
84057-7710
US

V. Phone/Fax

Practice location:
  • Phone: 801-607-2138
  • Fax: 801-225-2388
Mailing address:
  • Phone: 801-607-2138
  • Fax: 801-225-2388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number69123321-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: