# JAN NELSON NP-C, DBA, BALANCED WELLNESS MEDICAL CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427450535
- **Authorized official:** JANICE NELSON (OWNER)
- **Authorized official phone:** (208) 651-3322

## Contact information

- **Practice address:** 1328 N STANFORD LN, 101, LIBERTY LAKE, WA 99019-5034
- **Practice address phone:** (509) 891-7119
- **Mailing address:** PO BOX 2808, HAYDEN, ID 83835-2808
- **Mailing address phone:** (208) 651-3322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | AP60478189 | WA | Yes |

## Other

- **Enumeration date:** 09/19/2014
- **Last updated:** 09/19/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1538314257 | NPI | — |