Individual
MR. DARYL W NIELSEN I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
2450 AIRPORT RD, B215, LONGMONT, CO 80503-7921
(303) 678-1417
Mailing address
2450 AIRPORT RD, B215, LONGMONT, CO 80503-7921
(303) 678-1417
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
44636
CO
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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