| Doctor Name: | DR. BRANDON CLARK NIELSEN |
| NPI Number: | 1033559026 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | O.D. |
| License Number: | ODP:100311 |
| Business Practice Address: | 568 Falls Ave Twin Falls, ID - 833013314 |
| Business Phone Number: | 2082840650 |
| Business Fax Number: | |
| Mailing Address: | 568 Falls Ave, TWIN FALLS |
| State: | ID |
| Postal Code: | 833013314 |
| Phone Number: | 2082840650 |
| Fax Number: | |
| NPI Enumeration Date: | 07/05/2013 |
| NPI Last Update Date: | 10/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WP0200X |
| License Number: | ODP:100311 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | Optometrists who work in Pediatrics are concerned with the prevention, development, diagnosis, and treatment of visual problems in children. |