Individual
AMY M NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3209 S 23RD ST STE 340, TACOMA, WA 98405
(253) 272-5127
Mailing address
2420 S UNION AVE STE 200, TACOMA, WA 98405-1323
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30007085
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8894620
MDCR PTAN (K)
WA
01
—
G8912172
MDCR PTAN (P)
WA
Enumeration date
05/05/2006
Last updated
05/02/2019
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