DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Nielsen, Jennifer	DOIID	891856	NAIC NPN	17714532

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	6/14/2017	10/20/2020
Inactive	Non Resident	Agent	Casualty	6/14/2017	10/20/2020
Inactive	Non Resident	Agent	Life	9/17/2015	10/20/2020
Inactive	Non Resident	Agent	Health	9/17/2015	10/20/2020
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	National Casualty Company	301483	Agent - Casualty	1/20/2018	10/20/2020
Inactive	National Casualty Company	301483	Agent - Property	1/20/2018	10/20/2020
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	2/3/2017	9/24/2019
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	2/3/2017	9/24/2019
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	2/3/2017	9/24/2019
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	2/3/2017	9/24/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	DVM Insurance Agency	636779	Agent - Property	2/21/2018	10/20/2020
Inactive	DVM Insurance Agency	636779	Agent - Casualty	2/21/2018	10/20/2020
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Health	1/15/2019	9/24/2019
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Life	1/15/2019	9/24/2019
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Property	1/15/2019	10/20/2020
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Casualty	1/15/2019	10/20/2020