Individual
DR. JOHN F NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4061 OLD PESHTIGO RD, MARINETTE, WI 54143-3887
(715) 732-8050
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
75212-20
WI
207Q00000X
Family Medicine Physician
J8333
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099875903
—
TX
05
—
100170914
—
WI
01
—
8G9170
BLUE CROSS
TX
Enumeration date
06/14/2005
Last updated
12/10/2024
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