Provider Demographics
NPI:1992805543
Name:NELSON, RALPH DAVID (AUD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:DAVID
Last Name:NELSON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:DR
Other - First Name:R DAVID
Other - Middle Name:
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:119 E 5TH ST
Mailing Address - Street 2:PO BOX 17
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-5012
Mailing Address - Country:US
Mailing Address - Phone:712-262-7774
Mailing Address - Fax:
Practice Address - Street 1:119 E 5TH ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-5012
Practice Address - Country:US
Practice Address - Phone:712-262-7774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00075231H00000X
SD296A231H00000X
MN7115231H00000X
IA00177237700000X
MN2032237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist