Provider Demographics
NPI:1912016411
Name:NELSON, ADRIEN JEAN (MD)
Entity Type:Individual
Prefix:
First Name:ADRIEN
Middle Name:JEAN
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ADRIEN
Other - Middle Name:JEAN
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 ANTHONY CT
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3037
Mailing Address - Country:US
Mailing Address - Phone:914-671-7243
Mailing Address - Fax:
Practice Address - Street 1:2495 SHREVEPORT HWY 71 NORTH
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360
Practice Address - Country:US
Practice Address - Phone:318-473-0010
Practice Address - Fax:318-483-5036
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR155942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry