Provider Demographics
NPI:1518387729
Name:NIELSON, KAYLIE MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:KAYLIE
Middle Name:MARIE
Last Name:NIELSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 BEECHER XING N
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4573
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5454 WISCONSIN AVE STE 401
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6923
Practice Address - Country:US
Practice Address - Phone:301-215-4481
Practice Address - Fax:301-215-4488
Is Sole Proprietor?:No
Enumeration Date:2014-04-27
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist