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Individual

TALIA NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, FNP, PMHNP

Contact information

Practice address
6825 WHITE EGRET CT, TINLEY PARK, IL 60477-3973
(708) 833-1012
(866) 441-0962
Mailing address
6825 WHITE EGRET CT, TINLEY PARK, IL 60477-3973
(708) 833-1012
(866) 441-0962

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209014096
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209014096
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
277001021
IL LICENSE
IL
Enumeration date
04/04/2016
Last updated
09/21/2021
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