Provider Demographics
NPI:1528374873
Name:YVONNE M NELSON MD PLLC
Entity Type:Organization
Organization Name:YVONNE M NELSON MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-466-2162
Mailing Address - Street 1:4487 W 107TH PL
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-7603
Mailing Address - Country:US
Mailing Address - Phone:303-466-2162
Mailing Address - Fax:
Practice Address - Street 1:4487 W 107TH PL
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-7603
Practice Address - Country:US
Practice Address - Phone:303-466-2162
Practice Address - Fax:303-907-0796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty