Provider Demographics
NPI:1386383826
Name:NELSON, RACHEL LISBETH (DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LISBETH
Last Name:NELSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16403 S MANOR RD
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-2303
Mailing Address - Country:US
Mailing Address - Phone:952-454-1406
Mailing Address - Fax:
Practice Address - Street 1:14451 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-5708
Practice Address - Country:US
Practice Address - Phone:952-993-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist