Provider Demographics
NPI:1275172033
Name:NELSON, KATRICE N (RYT)
Entity Type:Individual
Prefix:
First Name:KATRICE
Middle Name:N
Last Name:NELSON
Suffix:
Gender:F
Credentials:RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11213 BLACK FOOT CT
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1493
Mailing Address - Country:US
Mailing Address - Phone:240-543-0283
Mailing Address - Fax:
Practice Address - Street 1:WELLSVIEW COTTAGE CENTER
Practice Address - Street 2:613 RIDGELY AVENUE
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:240-543-0283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty