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Individual

DR. KIERSTEN M NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1921 E 53RD ST, ANDERSON, IN 46013-4029
(317) 254-6480
(317) 259-8609
Mailing address
9795 CROSSPOINT BLVD, SUITE 100, INDIANAPOLIS, IN 46256-3354
(317) 254-6480
(317) 259-8609

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003543A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000665387
ANTHEM BCBS
IN
05
200914970C
IN
Enumeration date
07/23/2008
Last updated
09/09/2014
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