THERESA F NIELSEN (NPI# 1851462717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851462717 |
| Entity Type | Individual |
| Full Name | THERESA F NIELSEN |
| Credential | FNP |
| Practice Address |
2960 Tongass Ave Ketchikan AK 99901-5742 |
| Practice Telephone | 9072284900 |
| Practice Fax Number | 8008523264 |
| Mailing Telephone | 9072284900 |
| Mailing Fax Number | 8008523264 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2016-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
6696 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP128179 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1851462717 | 05 |
| Street Address |
2960 TONGASS AVE |
| City | KETCHIKAN |
| State | AK |
| Zip Code | 99901-5742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154315109 | Kathryn Lynn Price | Family Medicine | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2005-09-06 |
| 1427668300 | Morgan Wayne Holmes | Dentist | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2020-08-05 |
| 1073177424 | Maxx Ritchie Keizer | Pharmacist | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2019-04-30 |
| 1043763824 | Ying Kwok | Dentist | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2016-07-28 |
| 1780036491 | Andrea A. Lui | Family Medicine | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2016-07-06 |
| 1912370347 | Pamela Lee Rogers | Nurse Practitioner | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2015-11-06 |
| 1356745723 | Megan Hanifin | Counselor | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2014-10-14 |
| 1396153649 | Ketchikan Indian Corporation | Clinic/Center | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2014-07-31 |
| 1427460997 | Gerry Balluta | Case Manager/Care Coordinator | 2960 Tongass Ave, Ketchikan, AK 99901-5742 | 2014-06-02 |
| 1447670393 | Kristin Santroch | Dentist | 2960 Tongass Ave, Ketchikan, AK 99901 | 2014-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1174159222 | Helene Rae Simpson | Behavior Technician | 201 Deermont St, Ketchikan, AK 99901 | 2020-03-20 |
| 1003295155 | Suzanne Webb | Massage Therapist | 602 Dock St Ste 106, Ketchikan, AK 99901 | 2015-05-22 |
| 1093194342 | Kate Mortensen | Case Manager/Care Coordinator | 2690 Tongass Ave, Ketchikan, AK 99901 | 2015-05-20 |
| 1578879631 | Thomas Peter Ryan | Social Worker | 320 Bawden St. #318, Ketchikan, AK 99901 | 2010-08-27 |
| 1689820979 | Akeela Inc | Community Based Residential Treatment Facility, Mental Illness | 3050 Fifth Ave, Ketchikan, AK 99901 | 2008-08-18 |
| 1750565438 | Susan Marie Swift | Nurse Practitioner | 21 Jefferson Way, Suite 202, Psychiatry, Ketchikan, AK 99901 | 2007-12-18 |
| Find all providers in zip 99901 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306363734 | Amanda E Hulstine | Nurse Practitioner | 320 Bawden St Apt 313, Ketchikan, AK 99901-6544 | 2017-08-25 |
| 1639626997 | Adam Lee Randall | Nurse Practitioner | 283 Wood Rd, Ketchikan, AK 99901-9768 | 2016-09-04 |
| 1386071348 | Donna Lee Mathews Holman | Nurse Practitioner | 700 Water St, Ketchikan, AK 99901-6141 | 2013-10-03 |
| 1265874655 | Tammy Lorraine Earnest | Nurse Practitioner | 120 Carlanna Lake Rd, Ste 102, Ketchikan, AK 99901-5611 | 2013-07-25 |
| 1669707584 | Sarah Elizabeth Hines | Nurse Practitioner | 3528 Tongass Ave, Ketchikan, AK 99901-5635 | 2009-10-09 |
| 1295912608 | Maureen Northway | Nurse Practitioner | 130 Carlanna Lake Rd, Suite 201, Ketchikan, AK 99901-5669 | 2008-01-28 |
| 1790715886 | Lorraine Leilani Hill | Nurse Practitioner | 320 Bawden St, Suite 313, Ketchikan, AK 99901-6573 | 2006-07-04 |
| 1124593512 | Calm Harbor Health Clinic | Nurse Practitioner | 3528 Tongass Ave, Ketchikan, AK 99901-5635 | 2018-10-11 |
| 1639644024 | Cynthia Wornstaff Np LLC | Nurse Practitioner | 3528 Tongass Ave, Ketchikan, AK 99901-5635 | 2018-10-11 |
| 1174010938 | Carly Bernard | Nurse Practitioner | 605 Gateway Ct, Ketchikan, AK 99901-5672 | 2018-04-17 |
| Find all providers in KETCHIKAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.