Provider Demographics
NPI:1043635303
Name:NELLES, KRISTEN (RN)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:NELLES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5670 SCIOTO DARBY RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1389
Mailing Address - Country:US
Mailing Address - Phone:614-940-0026
Mailing Address - Fax:
Practice Address - Street 1:5583 WHISPERING OAK BLVD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9413
Practice Address - Country:US
Practice Address - Phone:614-940-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN278309163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool