Provider Demographics
NPI:1114208568
Name:NELSON, TERRY LYNN (RNFA)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LYNN
Last Name:NELSON
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4287 CLOUDVIEW DR S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-2781
Mailing Address - Country:US
Mailing Address - Phone:503-585-2260
Mailing Address - Fax:
Practice Address - Street 1:4287 CLOUDVIEW DR S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-2781
Practice Address - Country:US
Practice Address - Phone:503-585-2260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00039358163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant