Individual
RANDI NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
595 NW 11TH ST, HERMISTON, OR 97838-6600
(541) 567-2536
Mailing address
702 SUNSET DR, ONTARIO, OR 97914-3121
(541) 889-9167
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
AP60623651
WA
363L00000X
Nurse Practitioner
Primary
201710044NPPP
OR
363LF0000X
Family Nurse Practitioner
111815
NE
Other
Enumeration date
06/12/2015
Last updated
03/27/2018
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