Provider Demographics
NPI:1942589270
Name:NELSON, ERIN ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:NELSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4219 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3410
Mailing Address - Country:US
Mailing Address - Phone:405-644-5200
Mailing Address - Fax:
Practice Address - Street 1:6767 S YALE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3302
Practice Address - Country:US
Practice Address - Phone:918-494-3000
Practice Address - Fax:918-494-0003
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT4425225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKPT4425OtherPHYSICAL THERAPY