| Doctor Name: | TINA NELSON |
| NPI Number: | 1790119477 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 205 Graham St Montevallo, AL - 351154171 |
| Business Phone Number: | 2052532016 |
| Business Fax Number: | |
| Mailing Address: | Po.box2121, ALABASTER |
| State: | AL |
| Postal Code: | 35007 |
| Phone Number: | 2052532016 |
| Fax Number: | |
| NPI Enumeration Date: | 08/29/2013 |
| NPI Last Update Date: | 08/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171WH0202X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Contractor |
| Taxonomy Specialization: | Home Modifications |
| Taxonomy Definition: | |