Provider Demographics
NPI:1013694991
Name:NELSEN, ANNA KATHRYN
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:KATHRYN
Last Name:NELSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15072 SW 104TH ST APT 1306
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-3275
Mailing Address - Country:US
Mailing Address - Phone:317-853-9382
Mailing Address - Fax:
Practice Address - Street 1:1507 LEVANTE AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2416
Practice Address - Country:US
Practice Address - Phone:305-284-3570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer