| Doctor Name: | WENDELL TRUMAN NILSON |
| NPI Number: | 1205883576 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 5719918-1206 |
| Business Practice Address: | 1490 E Foremaster Dr Suite 130 Saint George, UT - 847904488 |
| Business Phone Number: | 4356340055 |
| Business Fax Number: | 4356285588 |
| Mailing Address: | 1490 E Foremaster Dr, Suite 130 SAINT GEORGE |
| State: | UT |
| Postal Code: | 847904488 |
| Phone Number: | 4356340055 |
| Fax Number: | 4356285588 |
| NPI Enumeration Date: | 05/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5719918-1206 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |