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General NPI Number Information
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NPI Number | 1124276811
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Entity Type | Individual
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Provider Name | DEBORAH L NIELSEN R.N. A.P.N
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Gender | Female
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 06/25/2021
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Provider Practice Location Address
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Address Line | 2500 W REYNOLDS ST
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City | PONTIAC
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State | IL
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Zip | 61764-9774
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Country | US
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Telephone | 815-844-5343
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Fax | 815-844-5715
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Provider Business Mailing Address
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Address Line | PO BOX 19248
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City | SPRINGFIELD
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State | IL
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Zip | 62794-9248
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Country | US
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Telephone | 217-528-7541
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209.007237
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License Number State | IL
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