MEDICARE: CHRISTINA RAE NELSON MAT, LAT, ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	1243	NE

General Provider Information

NPI Number	:	1245122993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA RAE NELSON MAT, LAT, ATC

Provider Business Mailing Address
First Line	:	4010 R AVE APT A4
Second Line	:
City	:	KEARNEY
State	:	NE
Zip	:	68847-2302
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4010 R AVE APT A4
Second Line	:
City	:	KEARNEY
State	:	NE
Zip	:	68847-2302
Country	:	US
Telephone Number	:	303-501-0799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2025
Last Update Date	:	07/17/2025

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