Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alexa Victoria Nickel, APRN

Individual provider Registered Nurse · NPI 1811488976

Alexa Victoria Nickel, APRN is a Nurse Practitioner in Salt Lake City, Utah. Qualified in 2018, 8 years ago. Practices with Mountainstar Specialty Services LLC, a 29-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
8
Licensed in
UT
In the registry since
2018
Specialties on file
2
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

1200 E 3900 S Unit G175
Salt Lake City, UT 84124-1300
Phone: (801) 268-7405
Fax: (801) 268-7435
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 9127639-4405 (UT)
Registered Nurse Taxonomy 163W00000X · Licence 9127639-3102 (UT)

Record details

NPI number1811488976
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorNo
NPI enumeratedMay 24, 2018
Last updated in NPPESJanuary 31, 2024
Certification dateJanuary 31, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Mountainstar Specialty Services Llc — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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