Provider Demographics
NPI:1366758815
Name:NELSON, ABBEY DEANE (OD)
Entity type:Individual
Prefix:DR
First Name:ABBEY
Middle Name:DEANE
Last Name:NELSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 W 30TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2690
Mailing Address - Country:US
Mailing Address - Phone:605-860-4003
Mailing Address - Fax:
Practice Address - Street 1:702 W DRAKE RD BLDG B
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5563
Practice Address - Country:US
Practice Address - Phone:970-221-4811
Practice Address - Fax:970-221-4815
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2812152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90001577068Medicaid
COOPT.0002812OtherCO OPTOMETRY LICENSE