Provider Demographics
NPI:1124621073
Name:NELSON, MICHELE PACE (RN)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:PACE
Last Name:NELSON
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 1:7000 EAST AVE # L-723
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-9698
Mailing Address - Country:US
Mailing Address - Phone:925-495-7087
Mailing Address - Fax:
Practice Address - Street 1:7000 EAST AVE # L-723
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-9698
Practice Address - Country:US
Practice Address - Phone:925-495-7087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA787284163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health