Healthcare Provider Details

I. General information

NPI: 1659065027
Provider Name (Legal Business Name): LAURA E NIELSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 E 100 S
PRICE UT
84501
US

IV. Provider business mailing address

PO BOX 867
PRICE UT
84501-0867
US

V. Phone/Fax

Practice location:
  • Phone: 435-637-5995
  • Fax: 541-813-2536
Mailing address:
  • Phone: 541-672-2691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: