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NPI Code Detail

MEDICARE: JENNA-LISE HELEN NEILSON RN

MEDICARE:   JENNA-LISE HELEN NEILSON  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse937991TX

General Provider Information

NPI Number : 1558861393
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA-LISE HELEN NEILSON RN
Provider Business Mailing Address
First Line : 2626 SCENIC POINT TRL APT 2433
Second Line :
City : ARLINGTON
State : TX
Zip : 76006-2635
Country : US
Telephone Number : 512-663-7434
Fax Number :
Provider Business Practice Location Address
First Line : 2626 SCENIC POINT TRL APT 2433
Second Line :
City : ARLINGTON
State : TX
Zip : 76006-2635
Country : US
Telephone Number : 512-663-7434
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2018
Last Update Date : 02/19/2018

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Directions to “ JENNA-LISE HELEN NEILSON RN” Practice Location

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