Provider Demographics
NPI:1144592890
Name:NELSON, STEVEN DEWARD (RN)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:DEWARD
Last Name:NELSON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11134
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-3334
Mailing Address - Country:US
Mailing Address - Phone:541-217-8763
Mailing Address - Fax:
Practice Address - Street 1:2151 W 15TH CT
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3460
Practice Address - Country:US
Practice Address - Phone:541-217-8763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR09500704RN374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician