Provider Demographics
NPI:1275235251
Name:NELSON, CARMEN DAWNETTE (APRN)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:DAWNETTE
Last Name:NELSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CARMEN
Other - Middle Name:DAWNETTE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 296
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67029-0296
Mailing Address - Country:US
Mailing Address - Phone:620-582-5226
Mailing Address - Fax:
Practice Address - Street 1:301 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:KS
Practice Address - Zip Code:67029-9758
Practice Address - Country:US
Practice Address - Phone:620-582-2136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82016-92363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily