Individual
MRS. LISA KAY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1910 CARBONADO RD, OSKALOOSA, IA 52577-2424
(641) 660-4903
Mailing address
PO BOX 71602, CLIVE, IA 50325-0602
(515) 243-2057
(515) 244-5570
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
A110101
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588990766
WELLMARK BCBS
IA
05
—
1588990766
—
IA
01
—
IN PROCESS
RR MEDICARE
IA
01
—
P01292197
RR MEDICARE
IA
Enumeration date
10/23/2009
Last updated
02/20/2019
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