Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 11453 | NV |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 11034571-1205 | UT |
NPI | 1477520575 |
---|---|
Provider Name | Jason H Nielson |
First Address | Henderson, NV 89074-1500 |
Second Address | Las Vegas, NV 89123-1903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 27/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100506550 | (05) | NV |
I48254 | (02) | NV |