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Individual
GLENN E. NELSON
Active
Individual
GLENN E. NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0310
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
701004
—
AZ
01
—
P00198920
RAIL ROAD MEDICARE
AZ
Enumeration date
10/04/2005
Last updated
01/20/2023
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