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Individual

DAVID ENOCH NELSON SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP-C

Contact information

Practice address
4900 BROADWAY, GARY, IN 46408-4605
(219) 237-5170
(219) 321-1931
Mailing address
213 N RACINE AVE, STE 100, CHICAGO, IL 60607-1644
(312) 733-9730
(773) 866-8014

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
041330644
IL
363LF0000X
Family Nurse Practitioner
Primary
28149900A
IN

Other

Enumeration date
01/03/2011
Last updated
08/11/2022
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