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General NPI Number Information
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NPI Number | 1700970837
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Entity Type | Individual
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Provider Name | KATHLEEN ANNE NIELSEN APRN BC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 100 CUMMINGS RD SUITE 207
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City | DANVERS
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State | MA
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Zip | 07848-2007
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Country | US
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Telephone | 978-791-3879
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Fax | 857-302-3549
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Provider Business Mailing Address
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Address Line | 239 BLACK POINT RD
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City | SCARBOROUGH
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State | ME
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Zip | 04074-9356
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Country | US
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Telephone | 973-222-2897
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 093527-23
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 45382
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 26NC05144300
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License Number State | NJ
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