Provider Demographics
NPI:1740875954
Name:NELSON, DANIEL K
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:K
Last Name:NELSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9649 MOHAWK DR
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-3639
Mailing Address - Country:US
Mailing Address - Phone:703-408-6261
Mailing Address - Fax:
Practice Address - Street 1:8323 EDEN DR
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-4130
Practice Address - Country:US
Practice Address - Phone:540-775-7187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker