Robert Nielson
Nurse Practitioner, Family in Roosevelt, UT. Individual provider (NPI-1).
NPI number1194413633
StatusActive
Last updated in NPPESApr 24, 2023
Details
- NPI
- 1194413633
- Entity type
- Individual (NPI-1)
- Name
- Robert Nielson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 24, 2023
- Certification date
- Apr 24, 2023
- Last updated
- Apr 24, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 9829616-4405 | UT | Yes |
Practice location
250 W 300 NRoosevelt, UT 84066-2336
Phone 435-722-4691
Mailing address
1259 Spruce DrRoosevelt, UT 84066-3800
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 12 Family Nurse Practitioner providers in Roosevelt · All 239 providers in Roosevelt
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