Provider Demographics
NPI:1710055058
Name:NELSON, DONNA K (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:K
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 880618
Mailing Address - Street 2:UNIVERSITY HEALTH CENTER 15TH & U STREETS
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68588-0618
Mailing Address - Country:US
Mailing Address - Phone:402-472-5000
Mailing Address - Fax:402-472-4593
Practice Address - Street 1:15TH & U STREETS
Practice Address - Street 2:UNIVERSITY HEALTH CENTER
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68588-0618
Practice Address - Country:US
Practice Address - Phone:402-472-5000
Practice Address - Fax:402-472-4593
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE15118207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025121400Medicaid
278250Medicare ID - Type Unspecified
B67823Medicare UPIN