Individual
BRADLEY WAYNE NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4242 FARNAM ST STE 550, OMAHA, NE 68131-2813
(402) 836-9900
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1782
NE
363AM0700X
Medical Physician Assistant
002471
IA
363AM0700X
Medical Physician Assistant
1782
NE
Other
Enumeration date
12/17/2013
Last updated
10/05/2020
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