Individual
STACI L NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
41W400 SILVER GLEN RD, ST CHARLES, IL 60175-8453
(608) 220-2607
Mailing address
41W400 SILVER GLEN RD, ST CHARLES, IL 60175-8453
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
041517712
IL
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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