Healthcare Provider Details

I. General information

NPI: 1912438144
Provider Name (Legal Business Name): ELISABETH K NELSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 03/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HEALTH PARK DR
LOUISVILLE CO
80027-9583
US

IV. Provider business mailing address

129 ZENITH AVE
LAFAYETTE CO
80026-1295
US

V. Phone/Fax

Practice location:
  • Phone: 303-673-1251
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number126976
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: