Healthcare Provider Details

I. General information

NPI: 1730120452
Provider Name (Legal Business Name): CHRISTINE PATRICE NIELSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 36TH ST STE H
VERO BEACH FL
32960-4898
US

IV. Provider business mailing address

1300 36TH ST STE H
VERO BEACH FL
32960-4898
US

V. Phone/Fax

Practice location:
  • Phone: 772-564-8383
  • Fax: 772-564-8377
Mailing address:
  • Phone: 772-564-8383
  • Fax: 772-564-8377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME91976
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberME91976
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: