Provider Demographics
NPI:1386852044
Name:NELSON, KAREN E (RN, LMT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:E
Last Name:NELSON
Suffix:
Gender:F
Credentials:RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 HUMMINGBIRD RD
Mailing Address - Street 2:
Mailing Address - City:MORRISDALE
Mailing Address - State:PA
Mailing Address - Zip Code:16858-9331
Mailing Address - Country:US
Mailing Address - Phone:814-577-8665
Mailing Address - Fax:
Practice Address - Street 1:203 HUMMINGBIRD RD
Practice Address - Street 2:
Practice Address - City:MORRISDALE
Practice Address - State:PA
Practice Address - Zip Code:16858-9331
Practice Address - Country:US
Practice Address - Phone:814-577-8665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN531716163WL0100X, 163WM1400X
174400000X
PAMSG000254225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No174400000XOther Service ProvidersSpecialist