Provider Demographics
NPI:1568744258
Name:NELSON, AMY CLAIRE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:CLAIRE
Last Name:NELSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 US HIGHWAY 31 N
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2142
Mailing Address - Country:US
Mailing Address - Phone:256-230-2799
Mailing Address - Fax:256-230-2839
Practice Address - Street 1:101 US HIGHWAY 31 N
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2142
Practice Address - Country:US
Practice Address - Phone:256-230-2799
Practice Address - Fax:256-230-2839
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist