NPI 1023671062
Jennifer Raae-Nielsen, MD
Practice location
- Address
- 1501 Hiland Ave, Burley, ID 83318-2688
- Phone
- (516) 593-1380
- Fax
- (516) 320-8983
- Mailing address
- PO Box 30180, Salt Lake City, UT 84130-0180
Registered specialties (4)
Emergency Medicine Physician
Primary
Emergency Medicine Physician
Emergency Medicine Physician
Student in an Organized Health Care Education/Training Program
Registry record
- NPI
- 1023671062
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 16 Apr 2019
- Record last updated
- 26 Aug 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.