| Doctor Name: | MS. LISA A NELSON |
| NPI Number: | 1033545025 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | R092478 |
| Business Practice Address: | 500 E 3rd St Russellville, AR - 728015204 |
| Business Phone Number: | 4799685048 |
| Business Fax Number: | 4799681498 |
| Mailing Address: | 500 E 3rd St, RUSSELLVILLE |
| State: | AR |
| Postal Code: | 728015204 |
| Phone Number: | 4799685048 |
| Fax Number: | 4799681498 |
| NPI Enumeration Date: | 09/23/2013 |
| NPI Last Update Date: | 09/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0200X |
| License Number: | R092478 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |