Individual
GALEN CARLOS NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
74 ECLIPSE CTR, BELOIT, WI 53511-3550
(608) 361-6051
(608) 361-6131
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1133-23
WI
363AM0700X
Medical Physician Assistant
085-001248
IL
363AM0700X
Medical Physician Assistant
1133-023
WI
Other
Enumeration date
10/20/2005
Last updated
10/07/2021
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