Provider Demographics
NPI:1982587788
Name:NELSON, CAWANNA M
Entity type:Individual
Prefix:MS
First Name:CAWANNA
Middle Name:M
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:PO BOX 351332
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-6332
Mailing Address - Country:US
Mailing Address - Phone:605-261-5503
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 351332
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-6332
Practice Address - Country:US
Practice Address - Phone:605-261-5503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty