Individual
DR. ANA D NIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1715 S WELLS AVE, MERIDIAN, ID 83642-5756
(208) 898-0304
(208) 898-0380
Mailing address
2320 E GALA ST, SUITE 400, MERIDIAN, ID 83642
(208) 898-0304
(208) 898-0380
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100016
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010139531
BLUE SHIELD IDAHO
ID
01
—
51385
DAVIS
ID
05
—
806419001
—
ID
01
—
V6960
BLUE CROSS IDAHO
ID
Enumeration date
06/15/2006
Last updated
09/10/2024
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