Healthcare Provider Details

I. General information

NPI: 1083482897
Provider Name (Legal Business Name): NATALIE MARIE NIELSEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 RUNNING HORSE RD
PLATTE CITY MO
64079-7707
US

IV. Provider business mailing address

901 E 104TH ST STE 900
KANSAS CITY MO
64131-3457
US

V. Phone/Fax

Practice location:
  • Phone: 816-532-7138
  • Fax:
Mailing address:
  • Phone: 816-532-7138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-109402
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17937
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number2024001459
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: