Healthcare Provider Details

I. General information

NPI: 1972823557
Provider Name (Legal Business Name): LAURIE S NELSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURIE S WOOD

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 COCOA AVE
HERSHEY PA
17033-1712
US

IV. Provider business mailing address

500 UNIVERSITY DR MC CA410
HERSHEY PA
17033-2360
US

V. Phone/Fax

Practice location:
  • Phone: 800-243-1455
  • Fax:
Mailing address:
  • Phone: 717-531-5208
  • Fax: 717-531-0119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT196655
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberMD450079
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD450079
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: