Healthcare Provider Details

I. General information

NPI: 1376407239
Provider Name (Legal Business Name): NICOLE BAER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2231 S HUNTER DR
SARATOGA SPRINGS UT
84045-6400
US

IV. Provider business mailing address

2231 S HUNTER DR
SARATOGA SPRINGS UT
84045-6400
US

V. Phone/Fax

Practice location:
  • Phone: 801-244-9779
  • Fax:
Mailing address:
  • Phone: 801-244-9779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: