Individual
STACY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, RD
Contact information
Practice address
500 W THOMAS RD, SUITE 600, PHOENIX, AZ 85013-4224
(602) 406-1140
Mailing address
500 W THOMAS RD, SUITE 600, PHOENIX, AZ 85013-4224
(602) 406-1140
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
863362
AZ
163W00000X
Registered Nurse
RN079860
AZ
Other
Enumeration date
07/15/2016
Last updated
07/15/2016
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