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General NPI Number Information
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NPI Number | 1841586526
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Entity Type | Individual
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Provider Name | LING QIN-NELSON D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 604 W BERRY ST
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City | FORT WAYNE
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State | IN
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Zip | 46802-2106
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Country | US
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Telephone | 260-423-1331
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Fax | 260-422-1046
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Provider Business Mailing Address
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Address Line | 604 W BERRY ST
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City | FORT WAYNE
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State | IN
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Zip | 46802-2106
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Country | US
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Telephone | 260-423-1331
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Fax | 260-422-1046
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5101019531
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 02005348A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 02005348A
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License Number State | IN
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