Individual
STACEY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
777 MURPHY RD, MEDFORD, OR 97504-8425
(443) 446-3262
Mailing address
777 MURPHY RD, MEDFORD, OR 97504-8425
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
201610238RN
OR
Other
Enumeration date
02/15/2017
Last updated
02/15/2017
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