Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 71004018A | IN |
N | 363LA2100X | Nurse Practitioner - Acute Care | F430641 | NY |
NPI | 1043577356 |
---|---|
Provider Name | Jennifer Ann Nielsen |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2012 |
Last Update Date | 06/01/2021 |