Individual
DEBRA ANN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2271 PINE RD, RUDOLPH, WI 54475
(715) 424-4671
Mailing address
2271 PINE RD, RUDOLPH, WI 54475
(715) 424-4671
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
317774-31
WI
Other
Enumeration date
10/24/2014
Last updated
10/24/2014
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