Individual
MARY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19010 BABROF DR, EAGLE RIVER, AK 99577-8627
(907) 952-0939
Mailing address
19010 BABROF DR, EAGLE RIVER, AK 99577-8627
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
7525
AK
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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