Provider Demographics
NPI:1629488382
Name:NELSEN, ASHTON (DPM)
Entity Type:Individual
Prefix:
First Name:ASHTON
Middle Name:
Last Name:NELSEN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:ASHTON
Other - Middle Name:
Other - Last Name:SCHUSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1207
Mailing Address - Country:US
Mailing Address - Phone:320-251-5444
Mailing Address - Fax:
Practice Address - Street 1:106 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1207
Practice Address - Country:US
Practice Address - Phone:320-251-5444
Practice Address - Fax:320-656-9590
Is Sole Proprietor?:No
Enumeration Date:2014-05-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN960213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery