Provider Demographics
NPI:1003447285
Name:NIELSEN, ERIK DANIEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:DANIEL
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50311-3533
Mailing Address - Country:US
Mailing Address - Phone:515-633-8606
Mailing Address - Fax:
Practice Address - Street 1:4100 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50311-3533
Practice Address - Country:US
Practice Address - Phone:515-633-8606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist