Provider Demographics
NPI:1902666811
Name:NELSON, KAMELAH L
Entity Type:Individual
Prefix:
First Name:KAMELAH
Middle Name:L
Last Name:NELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 WESTHEIMER RD APT 159
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5109
Mailing Address - Country:US
Mailing Address - Phone:832-856-1562
Mailing Address - Fax:
Practice Address - Street 1:6505 WESTHEIMER RD APT 159
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-5109
Practice Address - Country:US
Practice Address - Phone:832-856-1562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator