Healthcare Provider Details

I. General information

NPI: 1316920754
Provider Name (Legal Business Name): CHRISTINE F NELSON CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 BELLE AVE
LAKEWOOD OH
44107-4211
US

IV. Provider business mailing address

PO BOX 951101
CLEVELAND OH
44193-0005
US

V. Phone/Fax

Practice location:
  • Phone: 216-521-2228
  • Fax:
Mailing address:
  • Phone: 440-879-0081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberNS02812
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: