Provider Demographics
NPI:1396537122
Name:NELSON, SARAH DAWN
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:DAWN
Last Name:NELSON
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 1:507 I ST APT 4
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:NE
Mailing Address - Zip Code:69034-3420
Mailing Address - Country:US
Mailing Address - Phone:308-340-8070
Mailing Address - Fax:
Practice Address - Street 1:102 NORRIS AVE
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3884
Practice Address - Country:US
Practice Address - Phone:308-340-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities