Provider Demographics
NPI:1508301946
Name:NIELSEN, CIENNA LANDON (PA)
Entity Type:Individual
Prefix:MISS
First Name:CIENNA
Middle Name:LANDON
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3186 S MARYLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-2317
Mailing Address - Country:US
Mailing Address - Phone:702-731-8000
Mailing Address - Fax:866-477-7631
Practice Address - Street 1:3186 S MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2317
Practice Address - Country:US
Practice Address - Phone:702-731-8000
Practice Address - Fax:866-477-7631
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-20
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVPA1798363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant