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Individual

DANIEL NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
12800 N LAKE SHORE DR, MEQUON, WI 53097-2418
(262) 243-2129
Mailing address
1740 W GRAND AVE APT 203, PORT WASHINGTON, WI 53074-2094
(612) 695-5925

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3221-39
WI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/27/2023
Last updated
03/08/2026
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