Provider Information for 1467595330
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LAURIE L NELSON NP
Sex: Female
NPI: 1467595330
Last Updated: 2020-02-11
Certification Date: 2020-02-11
Certification Date: 2020-02-11
Details
| Name | Value | ||||||||||||||||
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| NPI | 1467595330 | ||||||||||||||||
| Enumeration Date | 2007-02-14 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 725 VIRGINIA ST DUNEDIN, FL 34698-6615 United States Phone: 727-734-4551 | Fax:727-736-8648 | ||||||||||||||||
| Primary Practice Address | 725 VIRGINIA ST DUNEDIN, FL 34698-6615 United States Phone: 727-734-4551 | Fax:727-736-8648 | ||||||||||||||||
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