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Contact Information

NIKOLE D SQUIRES, LAT, ATC, CPT
6748 W 9500 N
HIGHLAND, UT84003-3455
 Phone: 480-318-3949
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
 

Prevention Professional

405300000X
 

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
 

Sports Medicine

2083S0010X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for NIKOLE D SQUIRES · (Female)

NPI # 1215493838
Status Active
Credentials LAT, ATC, CPT
Entity Individual
Enumeration date 02/19/2019
Last updated 02/19/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 10877423-4810
  • UT License # TBA
  • Other TBA NATIONAL ACADEMY OF SPORTS MEDICINE
  • Other 2000031617 NATIONAL ATHLETIC TRAINERS' ASSOCIATION BOARD OF CERTIFICATION, INC.
  • UT Other 10877423-4810 UT DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSING
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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