Most Relevant Information
Provider Data
| NPI Number: | 1003346925 |
| Provider Name: | REBECCA NELSON |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/13/2017 |
| Last Updated: | 06/13/2017 |
Provider Practice Location
423 GREAT OAK DR
WAITE PARK
MN
563872507
Practice Location Phone/Fax
| Phone: | 3202815305 |
| Fax: | 3202815306 |
Provider Mailing Location
891 BELSLY BLVD
MOORHEAD
MN
565605055
Provider Mailing Phone/Fax
| Phone: | 2182874338 |
| Fax: | 2182875928 |