Provider Demographics
NPI:1124746755
Name:NAGEL, SEAN (CPSS)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:NAGEL
Suffix:
Gender:M
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 W CENTER ST # 355
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4605
Mailing Address - Country:US
Mailing Address - Phone:801-592-9417
Mailing Address - Fax:
Practice Address - Street 1:234 N OREM BLVD
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-6601
Practice Address - Country:US
Practice Address - Phone:801-691-0672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty