Provider Demographics
NPI:1134019607
Name:NELSON, TERQUOISE
Entity type:Individual
Prefix:
First Name:TERQUOISE
Middle Name:
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 1:103 E 2ND ST APT 233
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-4395
Mailing Address - Country:US
Mailing Address - Phone:804-614-8471
Mailing Address - Fax:
Practice Address - Street 1:103 E 2ND ST APT 233
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-4395
Practice Address - Country:US
Practice Address - Phone:804-614-8471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach