Individual
JULIE F NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2200 W 49TH ST STE 104, SIOUX FALLS, SD 57105-6550
(605) 336-6385
(605) 336-6513
Mailing address
PO BOX 5126, SIOUX FALLS, SD 57117-5126
(605) 335-1952
(605) 373-9971
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0408
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096657600
—
MN
01
—
351L4NE
BCBS
MN
01
—
4995209
BCBS
SD
05
—
6823043
—
SD
Enumeration date
05/20/2006
Last updated
02/21/2013
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