Provider Demographics
NPI:1730374984
Name:HEAL, GROW & THRIVE NAN NELSON MD AND ASSOCIATES LLC
Entity type:Organization
Organization Name:HEAL, GROW & THRIVE NAN NELSON MD AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-338-4278
Mailing Address - Street 1:32145 SEDGEFIELD OVAL
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-4756
Mailing Address - Country:US
Mailing Address - Phone:440-954-4113
Mailing Address - Fax:440-248-0136
Practice Address - Street 1:6200 SOM CENTER RD
Practice Address - Street 2:D-20
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2944
Practice Address - Country:US
Practice Address - Phone:440-248-0136
Practice Address - Fax:440-248-0191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350613132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty