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General NPI Number Information
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NPI Number | 1700846052
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Entity Type | Individual
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Provider Name | MICHELLE M NELSON MSN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 5366 386TH ST NE
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City | NORTH BRANCH
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State | MN
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Zip | 55056-5833
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Country | US
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Telephone | 651-674-8353
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Fax |
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Provider Business Mailing Address
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Address Line | 760 W 4TH ST
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City | RUSH CITY
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State | MN
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Zip | 55069-9063
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Country | US
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Telephone | 320-358-4784
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Fax | 320-358-4665
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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 | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number | R120703-5
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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 | R120703-5
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3093
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License Number State | MN
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