Provider Demographics
NPI:1487810057
Name:NELSON, KATHERINE ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DIVISION OF PAEDIATRIC MEDICINE--SICK KIDS
Mailing Address - Street 2:6415 BLACK WING, 555 UNIVERSITY AVENUE
Mailing Address - City:TORONTO
Mailing Address - State:ON
Mailing Address - Zip Code:M5G 1X8
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DIVISION OF PAEDIATRIC MEDICINE--SICK KIDS
Practice Address - Street 2:6415 BLACK WING, 555 UNIVERSITY AVENUE
Practice Address - City:TORONTO
Practice Address - State:ON
Practice Address - Zip Code:M5G 1X8
Practice Address - Country:CA
Practice Address - Phone:416-813-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192698208000000X
MA246469208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics