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Individual

MR. JOHN WILLIAM NIELSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1901 S 17TH ST, SUITE 1, WILMINGTON, NC 28401-6626
(910) 343-8424
(910) 343-6989
Mailing address
1901 S 17TH ST, SUITE 1, WILMINGTON, NC 28401-6626
(910) 343-8424
(910) 343-6989

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
101766
NC

Other

Enumeration date
11/29/2005
Last updated
01/11/2011
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