Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ETHAN MARK NIELSEN, PA
ActiveETHAN MARK NIELSEN, PA is a Physician Assistant healthcare provider located in PROVO, Utah. NPI 1154179844 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · PROVO, UT
Registration Details
- NPI Number
- 1154179844
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 8, 2024 (2.2868851937401 yrs)
- Last Updated
- Nov 21, 2025
- Licenses
-
14245351-1206 (UT)14245351-1206 (UT)
Practice Information
- Address
-
395 W BULLDOG BLVDPROVO, UT, 846043311Browse UT providers · Browse ZIP 84604
- Phone
- 8013577081
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Medical Physician Assistant
Other Physician Assistant Providers in PROVO, UT
| Name | Credential | NPI |
|---|---|---|
| JEFFREY D PIERSON | PA-C | 1861490609 |
| BRET D HILTON | PA | 1467451609 |
| STEVEN R NIELSON | PA | 1184623217 |
| JOHN ZACHARY | PA | 1871580829 |
| JOHN A WHITEHEAD | PA | 1619935053 |
| CORY NATHANAEL MILLER | PA | 1346298510 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.