Sandra Louise McNicoll, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2151388900 Issued in UT

Practice address

5801 Fashion Blvd Ste 175
Murray, UT 84107-8115

Phone

(801) 314-4544

NPI assigned

Jul 20, 2006

Last updated

Oct 16, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1073533188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-314-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 FASHION BLVD STE 175",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841078115",
            "telephone_number": "801-314-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNICOLL",
        "first_name": "SANDRA",
        "middle_name": "LOUISE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "UT",
            "license": "2151388900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J McLaughlin, MD
• Logan Arron McLean, MD
• Anna McMaster, SLP
• Julia Marlene McMillan, MS, CCC-SLP
• Michael McNeil, FNP-C, PMHNP-C
• Arien Nicole McOmber, M.A., MOT, OTR/L
• Linda McPharlin, ACMHC
• Shayne McQuivey, PA-C
• Kelli McStotts
• Rosemary Alice McVea, CSW, SUDC

• Gerontology Nurse Practitioner in Murray, UT
• Providers in Murray, UT by specialty
• Gerontology Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.