Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 41291 | AZ |
N | 207VE0102X | Reproductive Endocrinologist | 41291 | AZ |
Y | 207VG0400X | Gynecologist | 41291 | AZ |
NPI | 1194837930 |
---|---|
Provider Name | Dr. Linda R Nelson |
First Address | Phoenix, AZ 85012-2716 |
Second Address | Phoenix, AZ 85013-4224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 26/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
442083 | (05) | AZ |