Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 3998 | SD |
NPI | 1003823410 |
---|---|
Provider Name | Carol B Nelson |
First Address | Sioux Falls, SD 57105-1053 |
Second Address | Sioux Falls, SD 57105-1053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 16/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0004102 | BCBS (01) | IA |
0004102 | BCBS (01) | SD |
03A66MI | BCBS (01) | MN |
0992172 | (05) | IA |
6100440 | (05) | SD |
825523700 | (05) | MN |
G16833 | (02) |