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General NPI Number Information
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NPI Number | 1457844912
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Entity Type | Individual
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Provider Name | AVERY N NELSON MD
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Gender | Female
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Dates
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Enumeration Date | 06/10/2018
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 580 COURT ST NORTH BUILDING, LEVEL 1A
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City | KEENE
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State | NH
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Zip | 03431
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Country | US
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Telephone | 603-354-5496
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Fax | 603-354-5498
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Provider Business Mailing Address
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Address Line | PO BOX 810
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City | HANOVER
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State | NH
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Zip | 03755-0810
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Country | US
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Telephone | 603-308-1472
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 036176719
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 24202
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License Number State | NH
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