Provider Demographics
NPI:1013050558
Name:NELSON, ELIZABETH (ACUPUNCTURE PHYSICIA)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:ACUPUNCTURE PHYSICIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28L DERRYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-4333
Mailing Address - Country:US
Mailing Address - Phone:954-803-4943
Mailing Address - Fax:
Practice Address - Street 1:20 CRYSTAL AVENUE
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038
Practice Address - Country:US
Practice Address - Phone:954-803-4943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH275171100000X
NH7635225700000X
NH079777-21163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist