| Byron Nelson Pllc | |
|
1057 Highland Ave Louisville KY 40204-1960 | |
| (502) 994-0354 | |
| Not Available |
| Full Name | Byron Nelson Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1057 Highland Ave, Louisville, Kentucky |
| Authorized Official Name and Position | Christopher Byron Nelson (OWNER) |
| Authorized Official Contact | 5029940354 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Byron Nelson Pllc 1057 Highland Ave Louisville KY 40204-1960 Ph: (502) 994-0354 | Byron Nelson Pllc 1057 Highland Ave Louisville KY 40204-1960 Ph: (502) 994-0354 |
| NPI Number | 1215646567 |
|---|---|
| Provider Enumeration Date | 11/15/2022 |
| Last Update Date | 11/15/2022 |
| Certification Date | 11/15/2022 |
| Medicare PECOS PAC ID | 1456794189 |
|---|---|
| Medicare Enrollment ID | O20240208004230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215646567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christopher B Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508503731 PECOS PAC ID: 3375929938 Enrollment ID: I20221005000445 |
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