| NPI | 1043778731 |
|---|---|
| Former Name | KRISTIN ROSE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277003854) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 277003854) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 277003854) | |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2026-06-04 |