Individual
JAMES NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 FERRIS DR, BIG RAPIDS, MI 49307-2740
(231) 591-3780
Mailing address
736 VIVIAN LN, OXFORD, MI 48371-1447
(248) 628-5904
(248) 628-5904
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N298261
PHARMACY INTERN LICENSE
MI
Enumeration date
05/09/2018
Last updated
05/09/2018
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