Individual
JOHN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
648 MUSKOGEE BND, NEW BRAUNFELS, TX 78132-5008
(512) 828-9208
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
876564
TX
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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