Provider Demographics
NPI:1750039640
Name:NELSON, TERRESSA (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:TERRESSA
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 FORREST ST
Mailing Address - Street 2:
Mailing Address - City:GRAPELAND
Mailing Address - State:TX
Mailing Address - Zip Code:75844-3174
Mailing Address - Country:US
Mailing Address - Phone:210-772-4864
Mailing Address - Fax:
Practice Address - Street 1:215 FORREST ST
Practice Address - Street 2:
Practice Address - City:GRAPELAND
Practice Address - State:TX
Practice Address - Zip Code:75844-3174
Practice Address - Country:US
Practice Address - Phone:210-772-4864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-10
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX175720175F00000X
TX1063512163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No175F00000XOther Service ProvidersNaturopath