Doctor Name: | JUDITH M. NELSON |
NPI Number: | 1154333185 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, CNS |
License Number: | R0602893 |
Business Practice Address: | 6401 University Ave Ne Suite 304 Fridley, MN - 554324341 |
Business Phone Number: | 6517696250 |
Business Fax Number: | 6517696299 |
Mailing Address: | 2497 7th Ave E, Suite 101 SAINT PAUL |
State: | MN |
Postal Code: | 551092902 |
Phone Number: | 6517696437 |
Fax Number: | 6517696426 |
NPI Enumeration Date: | 08/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0808X |
License Number: | R0602893 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |