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NPI Profile for STEVEN E NICKMAN in LOGAN, UT.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant |
| NPI # | 1669459301 |
|
| Status | Active | |
| Credentials | PA-C (Physician Assistant-Certified) | |
| Entity | Individual | |
| Enumeration date | 12/23/2005 | |
| Last updated | 08/13/2025 - About 10 months ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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STEVEN E NICKMAN
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STEVEN E NICKMAN, PA-C