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NPI Code Detail

MEDICARE: MS. ANNTANETTE NELSON RN

MEDICARE: MS. ANNTANETTE NELSON RN
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
1163WA0400XAddiction (Substance Use Disorder) Registered Nurse333298AZ

General Provider Information

NPI Number : 1841159050
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANNTANETTE NELSON RN
Provider Business Mailing Address
First Line : 720 E MONTEBELLO AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-2543
Country : US
Telephone Number : 602-535-3382
Fax Number : 602-297-0779
Provider Business Practice Location Address
First Line : 720 E MONTEBELLO AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-2543
Country : US
Telephone Number : 602-535-3382
Fax Number : 602-297-0779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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