Basic Information
| Provider Information | |||||||||
| NPI: | 1851468367 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWITZER | ||||||||
| FirstName: | NIKKI | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SWITZER | ||||||||
| OtherFirstName: | NICOLE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 9350 S 150 E | ||||||||
| Address2: | SUITE150 | ||||||||
| City: | SANDY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840702702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013504602 | ||||||||
| FaxNumber: | 8013504753 | ||||||||
| Practice Location | |||||||||
| Address1: | 9350 S 150 E | ||||||||
| Address2: | SUITE150 | ||||||||
| City: | SANDY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840702702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013504602 | ||||||||
| FaxNumber: | 8013504753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2006 | ||||||||
| LastUpdateDate: | 11/03/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | 53769351205 | UT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.