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NPI Code Detail

MEDICARE: CRAIG DOUGLAS NIELSEN

MEDICARE: CRAIG DOUGLAS NIELSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner13314930-4405UT

General Provider Information

NPI Number : 1659222040
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG DOUGLAS NIELSEN
Provider Business Mailing Address
First Line : 150 W 100 N
Second Line :
City : VERNAL
State : UT
Zip : 84078-2036
Country : US
Telephone Number : 435-789-3342
Fax Number : 435-781-2628
Provider Business Practice Location Address
First Line : 150 W 100 N
Second Line :
City : VERNAL
State : UT
Zip : 84078-2036
Country : US
Telephone Number : 435-789-3342
Fax Number : 435-781-2628
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “ CRAIG DOUGLAS NIELSEN ” Practice Location

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