Provider Demographics
NPI:1548981525
Name:NELSON, SCOTT (PHARMD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:NELSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:SCOTT
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 419
Mailing Address - Street 2:
Mailing Address - City:REDWOOD FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56283-0419
Mailing Address - Country:US
Mailing Address - Phone:507-637-2911
Mailing Address - Fax:507-637-5869
Practice Address - Street 1:101 CARING WAY
Practice Address - Street 2:
Practice Address - City:REDWOOD FALLS
Practice Address - State:MN
Practice Address - Zip Code:56283-2624
Practice Address - Country:US
Practice Address - Phone:507-637-2911
Practice Address - Fax:507-637-5869
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist