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General NPI Number Information
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NPI Number | 1518558915
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Entity Type | Individual
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Provider Name | ANGELA MARIE NELSON CPHT
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Gender | Female
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 4142 AUSTIN BLUFFS PKWY
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-2928
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Country | US
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Telephone | 719-244-9783
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Fax | 719-266-0739
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Provider Business Mailing Address
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Address Line | 5330 ALTURAS DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80911-3407
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Country | US
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Telephone | 719-533-8519
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 10041900
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License Number State | CO
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