Individual
ANNA L NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7045 LIGHTHOUSE WAY, PERRYSBURG, OH 43551-7000
(419) 873-6836
(419) 873-6837
Mailing address
7045 LIGHTHOUSE WAY, PERRYSBURG, OH 43551-7000
(419) 873-6836
(419) 873-6837
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-122352
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104905
—
OH
Enumeration date
05/04/2011
Last updated
03/31/2020
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