Provider Demographics
NPI:1831480532
Name:E. HARBIN NELSON M.D. PLLC
Entity Type:Organization
Organization Name:E. HARBIN NELSON M.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HARBIN NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-458-7172
Mailing Address - Street 1:322 KAREN AVE
Mailing Address - Street 2:#2805
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-0412
Mailing Address - Country:US
Mailing Address - Phone:800-458-7172
Mailing Address - Fax:
Practice Address - Street 1:322 KAREN AVE
Practice Address - Street 2:#2805
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-0412
Practice Address - Country:US
Practice Address - Phone:800-458-7172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25967174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty