Individual
WILLIAM M NISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1441 W CENTRAL PARK, DAVENPORT, IA 52804
(563) 383-1900
(563) 884-4256
Mailing address
1441 W CENTRAL PARK, DAVENPORT, IA 52804
(563) 383-1900
(563) 884-4256
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
18981
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0169110
—
IA
Enumeration date
03/22/2006
Last updated
11/01/2011
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