Provider Demographics
NPI:1659672707
Name:NELSON, REBECCA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
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 1:2787 CHARTER ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-4607
Mailing Address - Country:US
Mailing Address - Phone:614-850-8700
Mailing Address - Fax:877-517-9302
Practice Address - Street 1:2787 CHARTER ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-4607
Practice Address - Country:US
Practice Address - Phone:614-850-8700
Practice Address - Fax:877-517-9302
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH27938183500000X
AZS017897183500000X
KY014882183500000X
MA27186183500000X
NE13352183500000X
NHR2227183500000X
OR0012178183500000X
TN34157183500000X
VA0202209828183500000X
WA60146991183500000X
AL008018183500000X
ARPD11411183500000X
LAPST019209183500000X
NY0546351183500000X
NC21309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist