Individual
LISA K NELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL DOCTOR
Contact information
Practice address
151 N SUNRISE AVE, SUITE 1009, ROSEVILLE, CA 95661-2924
(916) 782-3792
(916) 781-6562
Mailing address
PO BOX 396, ROSEVILLE, CA 95678-0396
(916) 780-1107
(916) 780-7007
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
AO62910
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A629100
—
CA
Enumeration date
03/09/2006
Last updated
02/25/2020
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