Provider Demographics
NPI:1639485253
Name:NELSON, MEGAN ROSE (MS)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ROSE
Last Name:NELSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 N MEADE STREET
Mailing Address - Street 2:APPLETON MEDICAL CENTER
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911
Mailing Address - Country:US
Mailing Address - Phone:920-735-7578
Mailing Address - Fax:920-380-1549
Practice Address - Street 1:1818 N MEADE STREET
Practice Address - Street 2:APPLETON MEDICAL CENTER
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911
Practice Address - Country:US
Practice Address - Phone:920-735-7578
Practice Address - Fax:920-380-1549
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS