Deerae Ann Nelson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8759 Issued in MN

Practice address

1415 Madison Ave
Detroit Lakes, MN 56501-4542

Phone

(218) 844-7119

Fax

(218) 844-7174

NPI assigned

Aug 23, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1073094504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45154 COUNTY HIGHWAY 31",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "565727541",
            "telephone_number": "701-261-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 MADISON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565014542",
            "telephone_number": "218-844-7119",
            "fax_number": "218-844-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DEERAE",
        "middle_name": "ANN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kurtis K Motschenbacher, PA-C
• Brenda K Muckenhirn, PT
• Collette Kay Murphy
• Anna Muzik
• Beth Marie Neitzel, MS, CCC-SLP
• Shelby Faith Nelson, RN
• Anna Joy Neu, FNP
• Renee Michelle Niemi
• Lorrae Nieves
• Julie Ann Nodsle, OTR/L

• Speech-Language Pathologist in Detroit Lakes, MN
• Providers in Detroit Lakes, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.