Provider Demographics
NPI:1740376839
Name:KAREN C NELSON MD PA
Entity type:Organization
Organization Name:KAREN C NELSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-241-7892
Mailing Address - Street 1:744 HORIZON CT
Mailing Address - Street 2:SUITE 350
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-3921
Mailing Address - Country:US
Mailing Address - Phone:970-241-7892
Mailing Address - Fax:970-241-1725
Practice Address - Street 1:744 HORIZON CT
Practice Address - Street 2:SUITE 350
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-3921
Practice Address - Country:US
Practice Address - Phone:970-241-7892
Practice Address - Fax:970-241-1725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO444602081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H55284Medicare UPIN