Individual
LISA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2375 E PRATER WAY, SPARKS, NV 89434-9641
(775) 331-7000
Mailing address
PO BOX 5849, RENO, NV 89513-5849
(775) 770-2043
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
778
NV
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
778
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002016200
—
NV
05
—
201660023
—
NV
Enumeration date
03/21/2006
Last updated
04/21/2010
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