Individual
WENDY E NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 WILLOW CREEK RD, PRESCOTT, AZ 86301-1668
(928) 445-2700
Mailing address
1003 WILLOW CREEK RD, PRESCOTT, AZ 86301-1668
(928) 445-2700
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1031044
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
10/08/2020
Last updated
10/08/2020
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