Individual
DAVID NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
939 N WISCONSIN ST, ELKHORN, WI 53121-4541
(262) 723-5055
(262) 723-5065
Mailing address
330 OSPREY LN, LINDENHURST, IL 60046-7957
(847) 770-3569
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18921-40
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18921-40
STATE LICENSE
WI
Enumeration date
02/20/2020
Last updated
02/20/2020
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