Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MT210475 | PA |
Y | 207VX0000X | Obstetrician | D89302 | MD |
NPI | 1134579360 |
---|---|
Provider Name | Sasha Nelson |
First Address | Columbia, MD 21044-3259 |
Second Address | Allentown, PA 18102-3648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2016 |
Last Update Date | 11/06/2020 |