Provider Demographics
NPI:1720421605
Name:NIELSEN, ADAM CHRISTOPHER (PHARM D)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:CHRISTOPHER
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 S JAMES M CAMPBELL BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-5193
Mailing Address - Country:US
Mailing Address - Phone:720-937-3462
Mailing Address - Fax:
Practice Address - Street 1:1202 S JAMES M CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-5193
Practice Address - Country:US
Practice Address - Phone:720-937-3462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist