Organization Name: | NELSON FAMILY PRACTICE PLLC |
NPI Number: | 1750621454 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHARON NELSON (OWNER/PROVIDER) |
Mailing Address: | 604 Hurst St Center |
State: | TX US |
Postal Code: | 759353414 |
Phone Number: | 9035985633 |
Fax Number: | |
NPI Enumeration Date: | 02/18/2013 |
NPI Last Update Date: | 02/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 250589 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |