Provider Demographics
NPI:1659789899
Name:NELSON, RUTH H (APRN)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:H
Last Name:NELSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:CRAB ORCHARD
Mailing Address - State:KY
Mailing Address - Zip Code:40419
Mailing Address - Country:US
Mailing Address - Phone:606-355-7800
Mailing Address - Fax:606-355-7803
Practice Address - Street 1:207 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CRAB ORCHARD
Practice Address - State:KY
Practice Address - Zip Code:40419
Practice Address - Country:US
Practice Address - Phone:606-355-7800
Practice Address - Fax:606-355-7803
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily