Individual provider Active NPI

Terry Lynn Nelson, RNFA

  • Registered Nurse First Assistant
  • Salem, OR
National Provider Identifier
1114208568
Registry record updated Aug 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
00039358 Issued in MN
Practice address
4287 Cloudview Dr S
Salem, OR 97302-2781
Phone
(503) 585-2260
NPI assigned
Aug 30, 2011
Last updated
Aug 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 00039358 MN Primary

Addresses

Primary practice location

4287 Cloudview Dr S
Salem, OR 97302-2781

Mailing address

4287 Cloudview Dr S
Salem, OR 97302-2781
Phone (503) 585-2260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00039358MNMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1114208568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4287 CLOUDVIEW DR S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022781",
            "telephone_number": "503-585-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4287 CLOUDVIEW DR S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022781",
            "telephone_number": "503-585-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TERRY",
        "middle_name": "LYNN",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MN",
            "license": "00039358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.