Individual
MRS. STEPHANIE BALLENTINE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
211 WAYNE ST, COLUMBIA, TN 38401-4526
(931) 560-3072
Mailing address
211 WAYNE ST, COLUMBIA, TN 38401-4526
(931) 490-1500
(931) 490-1502
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
251B00000X
TN
Other
Enumeration date
12/16/2010
Last updated
11/06/2013
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