Individual
AUTUMN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3955 56TH ST S STE D, FARGO, ND 58104-4845
(701) 417-7500
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(701) 234-2000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R37378
ND
363LF0000X
Family Nurse Practitioner
R37378
ND
Other
Enumeration date
08/11/2016
Last updated
03/30/2022
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