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General NPI Number Information
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NPI Number | 1013694991
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Entity Type | Individual
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Provider Name | ANNA KATHRYN NELSEN
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Gender | Female
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | WAKE FOREST UNIVERSITY PO BOX 7329
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City | WINSTON SALEM
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State | NC
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Zip | 27109
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Country | US
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Telephone | 336-758-5620
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Fax |
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Provider Business Mailing Address
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Address Line | 113 PEPPERMINT LN
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City | KERNERSVILLE
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State | NC
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Zip | 27284-9210
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Country | US
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Telephone | 317-853-9382
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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