Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | P31345 | MD |
N | 111NI0900X | Internist | P31345 | MD |
Y | 207RX0202X | Medical Oncology | 000000000 | TX |
NPI | 1124474705 |
---|---|
Provider Name | Dr. Blessie Elizabeth Nelson |
First Address | Galveston, TX 77555-0565 |
Second Address | Galveston, TX 77555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2016 |
Last Update Date | 11/06/2019 |