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NPI Code Detail

MEDICARE: ARI NELSON

MEDICARE: ARI NELSON
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner11816MN

General Provider Information

NPI Number : 1356193288
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARI NELSON
Provider Business Mailing Address
First Line : 1804 CLOQUET AVE
Second Line :
City : CLOQUET
State : MN
Zip : 55720-2141
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1804 CLOQUET AVE
Second Line :
City : CLOQUET
State : MN
Zip : 55720-2141
Country : US
Telephone Number : 218-879-2119
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2024
Last Update Date : 01/24/2025

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Directions to “ ARI NELSON ” Practice Location

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