Provider Demographics
NPI:1811966609
Name:NELSON, GABRIELE MARGARETE (LPN)
Entity type:Individual
Prefix:MRS
First Name:GABRIELE
Middle Name:MARGARETE
Last Name:NELSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1968 PALISADES DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-1023
Mailing Address - Country:US
Mailing Address - Phone:920-831-0331
Mailing Address - Fax:920-727-4322
Practice Address - Street 1:1968 PALISADES DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-1023
Practice Address - Country:US
Practice Address - Phone:920-831-0331
Practice Address - Fax:920-727-4322
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38252400OtherPROVIDER NUMBER