Individual
KIMBERLY A NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 355-3299
(812) 355-3290
Mailing address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 355-3299
(812) 355-3290
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71000261A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200280390
—
IN
Enumeration date
03/23/2006
Last updated
12/18/2020
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