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Individual

JASON WAYNE NIELSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1930 N LA CANADA DR STE 2, GREEN VALLEY, AZ 85614-4380
(520) 545-0592
Mailing address
1930 N LA CANADA DR STE 2, GREEN VALLEY, AZ 85614-4380

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
54209
MN
208600000X
Surgery Physician
Primary
56825
AZ
390200000X
Student in an Organized Health Care Education/Training Program
MN

Other

Enumeration date
06/15/2010
Last updated
09/25/2023
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