Provider Demographics
NPI:1992913974
Name:NELSON, KARI J (MD)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:J
Last Name:NELSON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:8020 CONSTITUTION PL NE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-7607
Mailing Address - Country:US
Mailing Address - Phone:505-998-3096
Mailing Address - Fax:505-998-3100
Practice Address - Street 1:8020 CONSTITUTION PL NE
Practice Address - Street 2:SUITE 202
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7607
Practice Address - Country:US
Practice Address - Phone:505-998-3096
Practice Address - Fax:505-998-3100
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2024-12-08
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Provider Licenses
StateLicense IDTaxonomies
NMMD2009-06322085R0202X, 2085R0204X
CAA1000552085R0204X, 2085R0202X
UT13867553-12052085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM302509Medicare PIN