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Individual

MRS. NAKITA NICHELLE NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
19021 ROCK MAPLE DR, HAGERSTOWN, MD 21742-2458
(301) 790-0170
Mailing address
19021 ROCK MAPLE DR, HAGERSTOWN, MD 21742-2458
(301) 790-0170

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
E0930X
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1720234214
MD
Enumeration date
08/15/2008
Last updated
07/07/2016
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