Provider Demographics
NPI:1710923396
Name:NELSON, CAROL A (ATC, EMT)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:NELSON
Suffix:
Gender:F
Credentials:ATC, EMT
Other - Prefix:
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Mailing Address - Street 1:80 HOUSE ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 WINTERGREEN AVE
Practice Address - Street 2:SOUTHERN CONNECTICUT STATE UNIVERSITY - MFH
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1059
Practice Address - Country:US
Practice Address - Phone:203-392-6007
Practice Address - Fax:203-392-6200
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer