Provider Demographics
NPI:1760665632
Name:NELSON, GEORGIA MAE (PHN)
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:MAE
Last Name:NELSON
Suffix:
Gender:F
Credentials:PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 MIRA LOMA DR
Mailing Address - Street 2:PUBLIC HEALTH NURSING
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-3500
Mailing Address - Country:US
Mailing Address - Phone:530-538-6455
Mailing Address - Fax:530-538-7297
Practice Address - Street 1:202 MIRA LOMA DR
Practice Address - Street 2:PUBLIC HEALTH NURSING
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-3500
Practice Address - Country:US
Practice Address - Phone:530-538-6455
Practice Address - Fax:530-538-7297
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 4193322083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine