Individual
THERESA F NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2960 TONGASS AVE, KETCHIKAN, AK 99901-5742
(907) 228-4900
(800) 852-3264
Mailing address
2960 TONGASS AVE, KETCHIKAN, AK 99901-5742
(907) 228-4900
(800) 852-3264
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
6696
CT
363LF0000X
Family Nurse Practitioner
Primary
AP128179
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851462717
—
VA
Enumeration date
11/13/2006
Last updated
09/06/2016
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