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General NPI Number Information
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NPI Number | 1134177561
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Entity Type | Individual
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Provider Name | SUSAN E. NELSON RN, FNP
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 1285 NININGER RD
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City | HASTINGS
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State | MN
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Zip | 55033-1086
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Country | US
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Telephone | 651-480-4200
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Fax | 651-480-4306
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Provider Business Mailing Address
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Address Line | 1285 NININGER RD
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City | HASTINGS
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State | MN
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Zip | 55033-1086
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Country | US
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Telephone | 651-480-4200
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Fax | 651-480-4306
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R079952-8
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 90758-030
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License Number State | WI
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