Provider Demographics
NPI:1801047550
Name:NIELSON, MARIAN JANIS (APRN-C)
Entity type:Individual
Prefix:MRS
First Name:MARIAN
Middle Name:JANIS
Last Name:NIELSON
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 W. 1500 N.
Mailing Address - Street 2:
Mailing Address - City:NEPHI
Mailing Address - State:UT
Mailing Address - Zip Code:84648
Mailing Address - Country:US
Mailing Address - Phone:435-445-3301
Mailing Address - Fax:435-445-3313
Practice Address - Street 1:48 W. 1500 N.
Practice Address - Street 2:
Practice Address - City:NEPHI
Practice Address - State:UT
Practice Address - Zip Code:84648
Practice Address - Country:US
Practice Address - Phone:435-445-3301
Practice Address - Fax:435-445-3313
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT194660-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily