Individual
KELLIE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
175 N MEDICAL DR E, SALT LAKE CITY, UT 84132-0001
(801) 585-6387
Mailing address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 585-6387
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
10493511-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2016
Last updated
02/28/2020
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