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NPI Code Detail

MEDICARE: ANGELA CAROL NELSON

MEDICARE: ANGELA CAROL 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
1172V00000XCommunity Health WorkerOR
2175T00000XPeer SpecialistOR

General Provider Information

NPI Number : 1902374275
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA CAROL NELSON
Provider Business Mailing Address
First Line : 2545 N ELDORADO AVE
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-6423
Country : US
Telephone Number : 541-883-3471
Fax Number : 541-883-3524
Provider Business Practice Location Address
First Line : 2545 N ELDORADO AVE
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-6423
Country : US
Telephone Number : 541-883-3471
Fax Number : 541-883-3524
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2018
Last Update Date : 12/12/2025

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Directions to “ ANGELA CAROL NELSON ” Practice Location

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