Healthcare Provider Details

I. General information

NPI: 1316307713
Provider Name (Legal Business Name): MS. KAREN NELSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2016
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 CONNECTICUT AVE NW STE 3A
WASHINGTON DC
20009-1220
US

IV. Provider business mailing address

1728 CONNECTICUT AVE NW STE 3A
WASHINGTON DC
20009-1220
US

V. Phone/Fax

Practice location:
  • Phone: 202-549-4111
  • Fax: 202-478-5130
Mailing address:
  • Phone: 202-549-4111
  • Fax: 202-478-5130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number422725
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: