Active NPI
Lloyd Issac Neilsen, RN, BSN
- Registered Nurse
- Fort Duchesne, UT
National Provider Identifier
1831534361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 193886-3102
- Practice address
- 6822 East 1000 South
Ft. Duchesne, UT 84026 - Phone
- (435) 725-6895
- NPI assigned
- May 10, 2013
- Last updated
- May 10, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 193886-3102 | UT | Primary |
Addresses
Primary practice location
6822 East 1000 South
Ft. Duchesne, UT 84026
Mailing address
6822 East 1000 South
Ft. Duchesne, UT 84026
Phone (435) 725-6895
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 193886-3102 | UT | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368144000000",
"number": "1831534361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6822 EAST 1000 SOUTH",
"city": "FT. DUCHESNE",
"state": "UT",
"postal_code": "84026",
"telephone_number": "435-725-6895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6822 EAST 1000 SOUTH",
"city": "FT. DUCHESNE",
"state": "UT",
"postal_code": "84026",
"telephone_number": "435-725-6895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEILSEN",
"first_name": "LLOYD",
"middle_name": "ISSAC",
"credential": "RN, BSN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-10",
"last_updated": "2013-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "UT",
"license": "193886-3102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Duchesne, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.