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Individual

DR. STEPHANIE MARIE NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1414 W FAIR AVE, SUITE 226, MARQUETTE, MI 49855-2675
(906) 225-3925
(906) 225-4838
Mailing address
26374 NETWORK PL, CHICAGO, IL 60673-1263
(906) 225-3630
(906) 225-4537

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5101019369
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1245518521
MI
Enumeration date
08/03/2011
Last updated
06/10/2021
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