Provider Demographics
NPI:1992755466
Name:NELSON, CHARON K (MSN, CNS)
Entity type:Individual
Prefix:MS
First Name:CHARON
Middle Name:K
Last Name:NELSON
Suffix:
Gender:F
Credentials:MSN, CNS
Other - Prefix:
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Mailing Address - Street 1:220 RUSKIN DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910
Mailing Address - Country:US
Mailing Address - Phone:719-572-6100
Mailing Address - Fax:719-572-6089
Practice Address - Street 1:2864 S CIRCLE DRIVE
Practice Address - Street 2:STE 600
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906
Practice Address - Country:US
Practice Address - Phone:719-314-4260
Practice Address - Fax:719-264-6616
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO71846163WP0808X, 2084P0804X
CO589364S00000X
COAPN.0000589-CNS364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO57082367Medicaid
CO44599Medicare PIN
COS30194Medicare UPIN