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Nisha Denae Andersen

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

754 S Main St, Saint George, UT 84770-5504

PECOS Enrollment

This provider is enrolled in PECOS as NISHA ANDERSEN.

Based on the most recent information from CMS, provider Nisha Denae Andersen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1679938831
Provider Type
Individual
Full Name
Andersen, Nisha Denae
Title
Mrs.
Credential
MSN, APRN, FNP-C

Gender
Female
Sole Proprietor
No
Enumeration Date
12/15/2015
Last Updated
8/4/2021

Contact Information

Practice Location

754 S Main St, Saint George, UT 84770-5504

(435) 628-2671

Unlisted Fax

Mailing Location

652 S Medical Center Dr Ste 300, St George, UT 84790-7266

(435) 251-3670

(435) 251-3671

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 6590850-4405 Utah

Nisha Denae Andersen

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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