Healthcare Provider Details

I. General information

NPI: 1396940144
Provider Name (Legal Business Name): KATHERINE E NELSON ND NATUROPATHIC PHYS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 ALGER
MARQUETTE MI
49855
US

IV. Provider business mailing address

PO BOX 643
MARQUETTE MI
49855-0643
US

V. Phone/Fax

Practice location:
  • Phone: 906-228-2298
  • Fax: 906-228-2298
Mailing address:
  • Phone: 906-228-2298
  • Fax: 906-228-2298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number0990000120
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: