Provider Demographics
NPI:1801125380
Name:NELSON, ADRIENNE M (DPT)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:M
Last Name:NELSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 BOULTON STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014
Mailing Address - Country:US
Mailing Address - Phone:609-731-1077
Mailing Address - Fax:
Practice Address - Street 1:658 BOULTON ST
Practice Address - Street 2:SUITE A
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4214
Practice Address - Country:US
Practice Address - Phone:609-731-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist