MEDICARE: RUTH ANN NELSON

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	163W00000X	Registered Nurse	1640238	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1640238	OTHER	CO	REGISTERED NURSE

General Provider Information

NPI Number	:	1952859639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH ANN NELSON

Provider Business Mailing Address
First Line	:	3080 E FLORA PL
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-6750
Country	:	US
Telephone Number	:	650-773-1719
Fax Number	:

Provider Business Practice Location Address
First Line	:	3080 E FLORA PL
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-6750
Country	:	US
Telephone Number	:	650-773-1719
Fax Number	:

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

Provider Enumeration Date	:	09/12/2016
Last Update Date	:	09/12/2016

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