Individual
BROOKS TANNER NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1901 TATE SPRINGS RD, LYNCHBURG, VA 24501-1109
(435) 773-3302
Mailing address
15503 MARCELLO CIR, NAPLES, FL 34110-2836
(435) 619-7275
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024180741
VA
Other
Enumeration date
12/09/2020
Last updated
01/25/2021
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