Michael Miracle
Individual provider Active NPI Registered Nurse · Mapleton, UT
NPI 1659200855 · NPPES record last updated May 15, 2026
Key facts
- NPI
- 1659200855
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 12082884-3102 (UT)
- Practice address
- 4793 S Olive Ave
Mapleton, UT 84664-5096 - Phone
- (385) 427-8956
- NPI assigned
- May 15, 2026
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12082884-3102 | UT | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 12082884-3102 | UT | Yes |
Addresses
Primary practice location
4793 S Olive Ave
Mapleton, UT 84664-5096
Mailing address
4793 S Olive Ave
Mapleton, UT 84664-5096
Phone (385) 427-8956
Other providers in Mapleton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.