Provider Demographics
NPI:1366731218
Name:NIELSEN, SARAH ELIZABETH (APRN, IFMCP, DNP)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:APRN, IFMCP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2341 S FERN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8589
Mailing Address - Country:US
Mailing Address - Phone:907-373-3335
Mailing Address - Fax:
Practice Address - Street 1:2341 S FERN ST STE 300
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8589
Practice Address - Country:US
Practice Address - Phone:907-373-3335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2019-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK365363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKP00960044OtherRAILROAD MEDICARE
AKNP0210Medicaid
AKNP0210Medicaid