Healthcare Provider Details

I. General information

NPI: 1700970837
Provider Name (Legal Business Name): KATHLEEN ANNE NIELSEN APRN BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WEST ST
CONCORD NH
03301-3548
US

IV. Provider business mailing address

29 SCHOOL ST
CONCORD NH
03301-4033
US

V. Phone/Fax

Practice location:
  • Phone: 603-225-0123
  • Fax:
Mailing address:
  • Phone: 603-226-7505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number45382
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number093527-23
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number26NC05144300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: