Provider Demographics
NPI:1285741561
Name:NELSON CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:NELSON CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HELMS-BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:CA
Authorized Official - Phone:402-334-1200
Mailing Address - Street 1:12309 GOLD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144
Mailing Address - Country:US
Mailing Address - Phone:402-334-1200
Mailing Address - Fax:402-334-0998
Practice Address - Street 1:12309 GOLD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144
Practice Address - Country:US
Practice Address - Phone:402-334-1200
Practice Address - Fax:402-334-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE707111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE098858Medicare ID - Type Unspecified
NE=========00Medicaid