| Doctor Name: | STACIE NELSON |
| NPI Number: | 1164518502 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | RN129463NP |
| Business Practice Address: | 144 Medical Center Dr Suite B Copperhill, TN - 373175005 |
| Business Phone Number: | 4234969214 |
| Business Fax Number: | 4234967809 |
| Mailing Address: | 144 Medical Center Dr, Suite B COPPERHILL |
| State: | TN |
| Postal Code: | 373175005 |
| Phone Number: | 4234969214 |
| Fax Number: | 4234967809 |
| NPI Enumeration Date: | 10/05/2006 |
| NPI Last Update Date: | 02/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RN129463NP |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |