Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225200000X | Physical Therapy Assistant | PTA0000002006 | TN |
Y | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1336282706 |
---|---|
Provider Name | Mrs. Karen Elizabeth Nelson |
First Address | Hendersonville, TN 37075-4104 |
Second Address | Hendersonville, TN 37075-4104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 01/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00D65 | PROVIDER NUMBER TN DMRS (01) | TN |
D65 | (05) | TN |