NPI age
6 years
Enumerated 2019-09-05
● Active
Type 1 · Individual
Marley Rae Nielson, PHYSICIAN ASSISTANT
Nielson is 1 of 57 physician assistant providers in Pocatello and 1 of 1263 in Idaho.
Primary specialty
Physician Assistant
Licensed in
—
0 states
Status
Active
No deactivations on record
Last NPPES update
2019-09-05
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1263 active physician assistant providers in Idaho.
NPI age
6 years
↓ 3 yr below median (9 yr)
State licenses
1 state
19% of peers hold multiple states
Subspecialties
0
35% of peers hold subspecialties
NPI lifetime · 2019 → 2026
2019-09Enumerated in NPPES
2019
2026
Where they practice
Practice location
333 N 18th Ave Ste B3
Pocatello, ID 832013358
Mailing address
882 Highland Blvd
Pocatello, ID 832044733
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.