Individual
KATHLEEN G NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
04176
AL
208000000X
Pediatrics Physician
Primary
G89222
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000019190
—
AL
05
—
000028945
—
AL
05
—
000083792
—
AL
01
—
510-19190
BC BS
AL
01
—
C76793
VIVA
—
Enumeration date
07/20/2006
Last updated
07/27/2018
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