Nikole Decker Squires, LAT, ATC, CPT in Highland, UT - Specialist/Technologist

Nikole Decker Squires, LAT, ATC, CPT is a Specialist/technologist - Athletic Trainer physician based in Highland, Utah. Nikole Decker Squires is licensed to practice in Utah (license number 10877423-4810) and her current practice location is 6748 W 9500 N, Highland, Utah. She can be reached at her office (for appointments etc.) via phone at (480) 318-3949.

NPI number for Nikole Decker Squires is 1215493838 and her current mailing address is 290 N 1260 W, Provo, Utah. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1215493838.

Contact Information

	Nikole Decker Squires, LAT, ATC, CPT
	6748 W 9500 N, Highland, UT 84003-3455
	(480) 318-3949
	Not Available

Physician's Profile

Full Name	Nikole Decker Squires
Gender	Female
Speciality	Specialist/technologist - Athletic Trainer
Location	6748 W 9500 N, Highland, Utah
Accepts Medicare Assignments	Does not participate in Medicare Program. She may not accept medicare assignment.

NPI Data:

NPI Number: 1215493838
Provider Enumeration Date: 02/19/2019
Last Update Date: 02/19/2019

Medical Identifiers

Medical identifiers for Nikole Decker Squires such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215493838	NPI	-	NPPES
10877423-4810	Other	UT	UT DIVISION OF OCCUPATIONAL & PROFESSIONAL LICENSING
2000031617	Other		NATIONAL ATHLETIC TRAINERS' ASSOCIATION BOARD OF CERTIFICATION, INC.
TBA	Other		NATIONAL ACADEMY OF SPORTS MEDICINE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2081S0010X	Physical Medicine & Rehabilitation - Sports Medicine	10877423-4810 (Utah)	Secondary
2083S0010X	Preventive Medicine - Sports Medicine	10877423-4810 (Utah)	Secondary
405300000X	Prevention Professional	TBA (Utah)	Secondary
2255A2300X	Specialist/technologist - Athletic Trainer	10877423-4810 (Utah)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nikole Decker Squires is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Nikole Decker Squires, LAT, ATC, CPT 290 N 1260 W, Provo, UT 84601-2436 Ph: (480) 318-3949	Nikole Decker Squires, LAT, ATC, CPT 6748 W 9500 N, Highland, UT 84003-3455 Ph: (480) 318-3949

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Nikole Decker Squires, LAT, ATC, CPT - Specialist/Technologist in Highland, UT