Individual
LORI A NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
2350 N LAKE DR, SUITE 300, MILWAUKEE, WI 53211-4528
(414) 298-7230
(414) 298-7231
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CSMCP CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 298-7230
(414) 298-7231
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1694
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39806000
—
WI
Enumeration date
07/04/2006
Last updated
03/31/2021
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