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Individual
MISS MARIE ELLEN NIELSEN
Active
Individual
MISS MARIE ELLEN NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA18155
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA18155
MEDICAL LICENSE
CA
01
—
PENDING
MEDICARE
CA
Enumeration date
01/26/2012
Last updated
01/04/2026
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