Provider Demographics
NPI:1922447234
Name:NIELSEN, LAURA KAY (DO)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:KAY
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 COLONIAL CIR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-9626
Mailing Address - Country:US
Mailing Address - Phone:515-285-3200
Mailing Address - Fax:515-256-9894
Practice Address - Street 1:801 COLONIAL CIR
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211-9626
Practice Address - Country:US
Practice Address - Phone:515-285-3200
Practice Address - Fax:515-256-9894
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-05358207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty