Provider Demographics
NPI:1699424416
Name:NIELSON, ALEXA NOEL
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:NOEL
Last Name:NIELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8761 THORNHILL DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN GROVE
Mailing Address - State:MO
Mailing Address - Zip Code:65711-2946
Mailing Address - Country:US
Mailing Address - Phone:801-362-7649
Mailing Address - Fax:
Practice Address - Street 1:8761 THORNHILL DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN GROVE
Practice Address - State:MO
Practice Address - Zip Code:65711-2946
Practice Address - Country:US
Practice Address - Phone:801-901-8077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-20
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife