Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 0101249480 | VA |
Y | 2081P2900X | Pain Medicine | D75116 | MD |
N | 2081P2900X | Pain Medicine | MD435220 | PA |
NPI | 1306011135 |
---|---|
Provider Name | Lori Elizabeth Nelson |
First Address | Washington, DC 20010-2921 |
Second Address | Bethesda, MD 20817-1809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2008 |
Last Update Date | 10/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102397704-0001 | (05) | PA |