MEDICARE: LAUREN 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
1	1041C0700X	Clinical Social Worker	SWB-20240248	NM

General Provider Information

NPI Number	:	1689119281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN NELSON

Provider Business Mailing Address
First Line	:	1490 CAMINO HERMOSA
Second Line	:
City	:	CORRALES
State	:	NM
Zip	:	87048-8676
Country	:	US
Telephone Number	:	253-228-5365
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 MOUNTAIN ROAD PL NE STE N
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7845
Country	:	US
Telephone Number	:	708-918-4469
Fax Number	:

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

Provider Enumeration Date	:	01/05/2017
Last Update Date	:	08/14/2025

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Directions to “ LAUREN NELSON ” Practice Location

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