Provider Demographics
NPI:1912970138
Name:NIELSEN, LINDA D (RN, MSN, FNP-C, GNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:D
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C, GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8301 HARCOURT RD STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2082
Practice Address - Country:US
Practice Address - Phone:317-415-6600
Practice Address - Fax:317-415-6649
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000416A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200169670Medicaid
IN561101Medicare UPIN
IN200169670Medicaid