Individual
LISA C NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3600 SAUNDERS AVE., RICHMOND, VA 23227-4347
(804) 358-1874
(804) 278-8977
Mailing address
3600 SAUNDERS AVE., RICHMOND, VA 23227-4347
(804) 358-1874
(804) 278-8977
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202002515
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004978013
—
VA
05
—
192086
—
VA
01
—
280488
OPTIMUM CHOICE
VA
05
—
31752
—
VA
05
—
40463
—
VI
05
—
4978013
—
VA
01
—
7756200
AETNA
VI
01
—
961110
SOUTHERN HEALTH
VA
01
—
ANTHEM
ANTHEM
VA
01
—
UNITED HEALTHCARE
UNITED HEALTHCARE
VA
Enumeration date
11/01/2006
Last updated
02/24/2012
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