Healthcare Provider Details

I. General information

NPI: 1992755466
Provider Name (Legal Business Name): CHARON K NELSON MSN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 02/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2864 S CIRCLE DRIVE STE 600
COLORADO SPRINGS CO
80906
US

IV. Provider business mailing address

220 RUSKIN DRIVE
COLORADO SPRINGS CO
80910
US

V. Phone/Fax

Practice location:
  • Phone: 719-314-4260
  • Fax: 719-264-6616
Mailing address:
  • Phone: 719-572-6100
  • Fax: 719-572-6089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number71846
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number589
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number71846
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAPN.0000589-CNS
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: