Individual
KELSEY JANET NIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3340 PROVIDENCE DR, ANCHORAGE, AK 99508-4691
(907) 562-2120
Mailing address
16515 SE SLATE ST, DAMASCUS, OR 97089-9123
(503) 481-8040
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202109936NP-PP
OR
Other
Enumeration date
10/10/2021
Last updated
10/10/2021
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