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NPI Code Detail

MEDICARE: MRS. VERA LYNN NELSON MD

MEDICARE: MRS. VERA LYNN NELSON MD
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
1207R00000XInternal Medicine Physician6563AWY

General Provider Information

NPI Number : 1265425938
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. VERA LYNN NELSON MD
Provider Business Mailing Address
First Line : PO BOX 50750
Second Line :
City : CASPER
State : WY
Zip : 82605-0750
Country : US
Telephone Number : 307-265-8300
Fax Number : 307-265-8313
Provider Business Practice Location Address
First Line : 419 S WASHINGTON ST
Second Line : SUITE 200
City : CASPER
State : WY
Zip : 82601-2951
Country : US
Telephone Number : 307-265-8300
Fax Number : 307-265-8313
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 09/13/2007

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