Healthcare Provider Details

I. General information

NPI: 1023141272
Provider Name (Legal Business Name): DOROTHY M NELSON NURSE'S AIDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 S CEDAR LN
PULASKI TN
38478-3502
US

IV. Provider business mailing address

18970 CAVE BRANCH RD
ELKMONT AL
35620-5808
US

V. Phone/Fax

Practice location:
  • Phone: 931-363-5506
  • Fax:
Mailing address:
  • Phone: 256-769-5590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: