Healthcare Provider Details

I. General information

NPI: 1063754463
Provider Name (Legal Business Name): ALICEN NELSON MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2013
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 NAVAJO ST
DENVER CO
80211-2440
US

IV. Provider business mailing address

601 N BROADWAY # MC3240
DENVER CO
80203-3407
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberDR.0059597
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0059597
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: