Ethan Mark Nielsen, PA
Ethan Mark Nielsen, PA is a Physician Assistant in Provo, Utah. Qualified in 2025, 1 year ago. Licensed in Utah.
- Years since qualifying
- 1
- Licensed in
- UT
- In the registry since
- 2024
- Specialties on file
- 2
What do these letters mean?
- PA — Physician Assistant
- A licensed clinician who examines, diagnoses and treats under a physician's supervision.
Practice location Address checks out
395 W Bulldog BlvdProvo, UT 84604-3311
Phone: (801) 357-7081
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 14245351-1206 (UT) |
|---|---|
| Medical Physician Assistant | Taxonomy 363AM0700X · Licence 14245351-1206 (UT) |
Record details
| NPI number | 1154179844 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA |
| Sole proprietor | No |
| NPI enumerated | May 8, 2024 |
| Last updated in NPPES | November 21, 2025 |
| Certification date | November 21, 2025 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2025 (1 years in practice) |
| Accepts Medicare assignment | Not indicated |
Other providers in Provo
-
Anna Nash, PA-C
1055 N 500 W Ste 102, Provo, UT 84604-3305 · (801) 374-2367
-
Kelsie Nicole Nelson
1800 Novell Pl, Provo, UT 84606-6171 · (801) 375-5125
-
Michael Lee Nelson, PA
1750 N Wymount Terrace Dr, Provo, UT 84602-1017 · (801) 422-5156
-
Callie Nielsen
333 W 2230 N Ste 225, Provo, UT 84604-6709 · (801) 477-7189
-
Steven R Nielson, PA
280 W River Park Dr Ste 120, Provo, UT 84604-5764 · (801) 229-2011
-
Christy Palmer, PA-C
1900 N State St, Provo, UT 84604-1341 · (801) 373-2001
-
Haley Parker, PA-C
589 S State St, Provo, UT 84606-5056 · (801) 429-2000
-
Heather Parkinson, PA-S
5314 N 250 W Ste 220, Provo, UT 84604-7746 · (801) 225-8484