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NPI Code Detail

MEDICARE: REANN NELSON

MEDICARE: REANN 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1881545275
Entity Type Code : Individual
Provider Name (Legal Business Name) : REANN NELSON
Provider Business Mailing Address
First Line : 8924 S MAPLE CITY RD
Second Line :
City : MAPLE CITY
State : MI
Zip : 49664-9723
Country : US
Telephone Number : 231-492-7013
Fax Number :
Provider Business Practice Location Address
First Line : 10781 E CHERRY BEND RD
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-5249
Country : US
Telephone Number : 231-268-0007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “ REANN NELSON ” Practice Location

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