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General NPI Number Information
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NPI Number | 1265897714
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Entity Type | Individual
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Provider Name | ALICE L NELSON HAD
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Gender | Female
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 33 STATE RD SUITE B & C
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City | PRINCETON
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State | NJ
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Zip | 08540-1304
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Country | US
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Telephone | 609-924-0534
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Fax | 609-924-8636
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Provider Business Mailing Address
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Address Line | 6700 WASHINGTON AVE S
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-3405
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Country | US
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Telephone | 800-328-8602
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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 | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 25MG00135200
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License Number State | NJ
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