Provider Demographics
NPI:1699588509
Name:BUTTERFIELD, NIKKI JEAN
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:JEAN
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12302 S MIDAS QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-2444
Mailing Address - Country:US
Mailing Address - Phone:801-598-9014
Mailing Address - Fax:
Practice Address - Street 1:12302 S MIDAS QUARRY RD
Practice Address - Street 2:
Practice Address - City:HERRIMAN
Practice Address - State:UT
Practice Address - Zip Code:84096-2444
Practice Address - Country:US
Practice Address - Phone:801-598-9014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8175153-3102163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice