Provider Demographics
NPI:1487982427
Name:NELSON, ANITRIS LACHELE
Entity type:Individual
Prefix:
First Name:ANITRIS
Middle Name:LACHELE
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 1:1627 E SILVER SPRINGS BLVD
Mailing Address - Street 2:STE. D
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-8247
Mailing Address - Country:US
Mailing Address - Phone:352-433-2610
Mailing Address - Fax:352-433-2621
Practice Address - Street 1:1627 E SILVER SPRINGS BLVD
Practice Address - Street 2:STE. D
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-8247
Practice Address - Country:US
Practice Address - Phone:352-433-2610
Practice Address - Fax:352-433-2621
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230877372600000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion