MEDICARE: SARAH NELSON RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WX0003X	Inpatient Obstetric Registered Nurse	1681846	CO

General Provider Information

NPI Number	:	1083437685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH NELSON RN

Provider Business Mailing Address
First Line	:	960 N GRANT ST APT 625
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-2990
Country	:	US
Telephone Number	:	817-789-0568
Fax Number	:

Provider Business Practice Location Address
First Line	:	960 N GRANT ST APT 625
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-2990
Country	:	US
Telephone Number	:	817-789-0568
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	11/04/2024

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