Provider Demographics
NPI:1245955418
Name:NELSON, JOSEPH
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:NELSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5821 PRAIRIE VIEW RD
Mailing Address - Street 2:
Mailing Address - City:TOWNER
Mailing Address - State:ND
Mailing Address - Zip Code:58788-9575
Mailing Address - Country:US
Mailing Address - Phone:701-537-3499
Mailing Address - Fax:
Practice Address - Street 1:350 58TH ST NE
Practice Address - Street 2:
Practice Address - City:TOWNER
Practice Address - State:ND
Practice Address - Zip Code:58788-5400
Practice Address - Country:US
Practice Address - Phone:701-500-2966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No385H00000XRespite Care FacilityRespite Care