Individual
HOLLEY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2120 E MONONA DR, PHOENIX, AZ 85024-4417
(602) 867-9011
Mailing address
2120 E MONONA DR, PHOENIX, AZ 85024-4417
(602) 867-9011
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP047799
AZ
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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