Provider Demographics
NPI:1366537219
Name:NIELSEN, MICHELE CHRISTINE (DPT)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:CHRISTINE
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2126 GREAT NECK SQ
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2202
Mailing Address - Country:US
Mailing Address - Phone:757-578-2197
Mailing Address - Fax:757-578-2330
Practice Address - Street 1:2126 GREAT NECK SQ
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2202
Practice Address - Country:US
Practice Address - Phone:757-578-2197
Practice Address - Fax:757-578-2330
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204696225100000X, 2251S0007X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541853904OtherCOMMERCIAL
VA541853904OtherAETNA
1366537219OtherMEDICARE RAILROAD
VA192612OtherANTHEM
1366537219OtherMEDICARE RAILROAD