Individual
REGINA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3147 W 65TH AVE, MERRILLVILLE, IN 46410-2978
(219) 487-5031
Mailing address
3147 W 65TH AVE, MERRILLVILLE, IN 46410-2978
(219) 487-5031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71005745A
IN
Other
Enumeration date
03/10/2015
Last updated
04/21/2017
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