Individual
MRS. CONNIE MICHELLE NELSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1115 B ST, PLUMMER, ID 83851
(208) 686-1931
(208) 686-1035
Mailing address
170 LARCH RD, ST MARIES, ID 83861-7150
(208) 245-2116
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
N25223
ID
Other
Enumeration date
09/27/2005
Last updated
07/08/2007
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