Healthcare Provider Details

I. General information

NPI: 1912829722
Provider Name (Legal Business Name): MRS. BRIANNA NIELSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SAINT ANDREWS BLVD APT 3201
WINTER PARK FL
32792-4273
US

IV. Provider business mailing address

200 SAINT ANDREWS BLVD APT 3201
WINTER PARK FL
32792-4273
US

V. Phone/Fax

Practice location:
  • Phone: 703-635-6769
  • Fax:
Mailing address:
  • Phone: 703-635-6769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07260565
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: