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NPI Code Detail

MEDICARE: KARA NELSEN APRN

MEDICARE: KARA NELSEN APRN
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
1363LF0000XFamily Nurse Practitioner6687CT

General Provider Information

NPI Number : 1902350382
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARA NELSEN APRN
Provider Business Mailing Address
First Line : 30 JORDAN LN
Second Line :
City : WETHERSFIELD
State : CT
Zip : 06109-1278
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 925 SULLIVAN AVE
Second Line : SUITE 1
City : SOUTH WINDSOR
State : CT
Zip : 06074-2025
Country : US
Telephone Number : 860-644-1521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2016
Last Update Date : 08/18/2016

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