Nelson, Michelle R

Nelson, Michelle R is an individual health care provider with primary practice located at 6308 8Th Ave Suite 505, Kenosha WI 53143-5031. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Nelson, Michelle R can be contacted via phone (262) 656-3525.

Contact Information

Primary practice address
6308 8Th Ave Suite 505 Kenosha WI 53143-5031
Fax: (262) 656-3560
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1662023 Wisconsin

Profile Details

NPI number 1063493088
LBN Legal business name Nelson, Michelle R
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated Nov 22nd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063493088 NPPES
Wisconsin MEDICAID 41979800

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