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NPI Code Detail

MEDICARE: MARCUS J NIELSEN PA

MEDICARE: MARCUS J NIELSEN PA
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
1363A00000XPhysician Assistant1506NE

General Provider Information

NPI Number : 1821311853
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCUS J NIELSEN PA
Provider Business Mailing Address
First Line : PO BOX 406
Second Line :
City : SAINT PAUL
State : NE
Zip : 68873-0406
Country : US
Telephone Number : 308-754-4421
Fax Number : 308-754-2303
Provider Business Practice Location Address
First Line : 1113 SHERMAN ST
Second Line :
City : SAINT PAUL
State : NE
Zip : 68873-1546
Country : US
Telephone Number : 308-754-4421
Fax Number : 308-754-2303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2010
Last Update Date : 03/28/2025

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Directions to “ MARCUS J NIELSEN PA” Practice Location

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