Nielsen, Diane Rae
Nielsen, Diane Rae is an individual health care provider with primary practice located at 3430 Washington Parkway , Idaho Falls ID 83404. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Nielsen, Diane Rae can be contacted via phone (208) 523-3060.Contact Information
Primary practice address
3430 Washington Parkway
Idaho Falls ID 83404
Phone: (208) 523-3060
Fax: (208) 523-0028
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | PA178 | Idaho |
Profile Details
| NPI number | 1205940962 |
|---|---|
| LBN Legal business name | Nielsen, Diane Rae |
| Credentials | PA C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Sep 10th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205940962 | NPPES |
| Idaho | Other | PAKY2 | BLUE CROSS |
| Idaho | MEDICAID | 004378700 | BLUE CROSS |
| Idaho | Other | 000010016257 | BLUE CROSS |
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