Individual
ALEXANDRA MARIE NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2545
Mailing address
11302 W HICKORY HILL CT, BOISE, ID 83713-2467
(540) 641-0520
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
61047
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61047
STATE NP LICENSE
ID
Enumeration date
03/22/2019
Last updated
02/20/2024
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