Provider Demographics
NPI:1871875575
Name:NELSON, BARBARA MAE (RPH)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:MAE
Last Name:NELSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 ALBERT PIKE RD
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-4055
Mailing Address - Country:US
Mailing Address - Phone:501-318-1238
Mailing Address - Fax:501-318-1466
Practice Address - Street 1:1404 ALBERT PIKE RD
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-4055
Practice Address - Country:US
Practice Address - Phone:501-318-1238
Practice Address - Fax:501-318-1466
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD09467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist