Provider Demographics
NPI:1750069209
Name:NIELSEN, ROBIN (APRN)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 ROCK SPRINGS RD # 367
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-2229
Mailing Address - Country:US
Mailing Address - Phone:407-650-2558
Mailing Address - Fax:407-650-2558
Practice Address - Street 1:2101 PREVATT ST
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6131
Practice Address - Country:US
Practice Address - Phone:352-589-4774
Practice Address - Fax:352-589-5092
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11027270363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL118774100Medicaid