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General NPI Number Information
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NPI Number | 1518251107
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Entity Type | Individual
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Provider Name | NICOLE CHOULES AU.D.
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Gender | Female
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 07/11/2011
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Provider Practice Location Address
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Address Line | 150 N 1100 E UNIT 29
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City | WASHINGTON
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State | UT
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Zip | 84780-2608
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Country | US
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Telephone | 801-319-2772
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Fax |
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Provider Business Mailing Address
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Address Line | 150 N 1100 E UNIT 29
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City | WASHINGTON
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State | UT
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Zip | 84780-2608
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 7997609-4103
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number | 7997609-4103
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License Number State | UT
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