Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 20958 | NV |
N | 207RI0011X | Interventional Cardiology | A117915 | CA |
NPI | 1093027799 |
---|---|
Provider Name | Dr. Bradley Clark Nelson |
First Address | Reno, NV 89502-1576 |
Second Address | Reno, NV 89502-1198 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2010 |
Last Update Date | 08/06/2021 |