Provider Demographics
NPI:1649505660
Name:NIELSEN, BARBARA A (LPN)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BLAINE PL
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5501
Mailing Address - Country:US
Mailing Address - Phone:631-462-2334
Mailing Address - Fax:631-462-2334
Practice Address - Street 1:9 BLAINE PL
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5501
Practice Address - Country:US
Practice Address - Phone:631-462-2334
Practice Address - Fax:631-462-2334
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125903-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse