Provider Demographics
NPI:1265425938
Name:NELSON, VERA LYNN (MD)
Entity type:Individual
Prefix:MRS
First Name:VERA
Middle Name:LYNN
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 50750
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82605-0750
Mailing Address - Country:US
Mailing Address - Phone:307-265-8300
Mailing Address - Fax:307-265-8313
Practice Address - Street 1:419 S WASHINGTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2951
Practice Address - Country:US
Practice Address - Phone:307-265-8300
Practice Address - Fax:307-265-8313
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY6563A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H40552Medicare UPIN
WYW21284Medicare PIN