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Individual
SANDRA L NELSON
Active
Individual
SANDRA L NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
121268
IA
363LP0200X
Pediatric Nurse Practitioner
R 089542-2
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
641042100
—
MN
Enumeration date
03/31/2006
Last updated
07/16/2009
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