Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 2505 | MN |
N | 363LP2300X | Nurse Practitioner - Primary Care | R173566-2 | MN |
NPI | 1053750422 |
---|---|
Provider Name | Erin Elizabeth Nelson |
First Address | Buffalo, MN 55313-1947 |
Second Address | Buffalo, MN 55313-1947 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2013 |
Last Update Date | 10/11/2020 |