Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS016821 | PA |
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | S3258 | TX |
N | 207V00000X | Obstetrician & Gynecologist | OS016821 | PA |
N | 207V00000X | Obstetrician & Gynecologist | S3258 | TX |
NPI | 1144573148 |
---|---|
Provider Name | Meaghan Cecelia Nelsen |
First Address | Fort Worth, TX 76107-2553 |
Second Address | Fort Worth, TX 76107-2553 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2012 |
Last Update Date | 19/08/2019 |