Provider Demographics
NPI:1326104902
Name:NELSON, RAYMOND DANIEL
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:DANIEL
Last Name:NELSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 185TH ST
Mailing Address - Street 2:
Mailing Address - City:LESTER PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55354-7952
Mailing Address - Country:US
Mailing Address - Phone:320-395-4207
Mailing Address - Fax:
Practice Address - Street 1:1504 185TH ST
Practice Address - Street 2:
Practice Address - City:LESTER PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55354-7952
Practice Address - Country:US
Practice Address - Phone:320-395-4207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23066207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology