Provider Demographics
NPI:1861474538
Name:NELSON, DEBORAH E (RPT)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:E
Last Name:NELSON
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36602-4011
Mailing Address - Country:US
Mailing Address - Phone:251-431-5818
Mailing Address - Fax:251-431-5810
Practice Address - Street 1:305 N WATER ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36602-4011
Practice Address - Country:US
Practice Address - Phone:251-431-5818
Practice Address - Fax:251-431-5810
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1919225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-98076OtherBC/BS PROVIDER #
AL000098076NELMedicare ID - Type Unspecified