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NPI Code Detail

MEDICARE: COREY ALLEN NELSON

MEDICARE:   COREY ALLEN 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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1396508354
Entity Type Code : Individual
Provider Name (Legal Business Name) : COREY ALLEN NELSON
Provider Business Mailing Address
First Line : 90 CAMDEN DR
Second Line :
City : CHARLES TOWN
State : WV
Zip : 25414-5043
Country : US
Telephone Number : 681-247-9244
Fax Number :
Provider Business Practice Location Address
First Line : 90 CAMDEN DR
Second Line :
City : CHARLES TOWN
State : WV
Zip : 25414-5043
Country : US
Telephone Number : 681-247-9244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2024
Last Update Date : 02/02/2024

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Directions to “ COREY ALLEN NELSON ” Practice Location

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