Jan Nelson NP-C, Dba, Balanced Wellness Medical Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

AP60478189 Issued in WA

Legal business name

JAN NELSON NP-C, DBA, BALANCED WELLNESS MEDICAL CLINIC

Practice address

1328 N Stanford LN
101
Liberty Lake, WA 99019-5034

Phone

(509) 891-7119

NPI assigned

Sep 19, 2014

Organization subpart

No

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

Authorized official

Name

Janice Nelson

Title

Owner

Phone

(208) 651-3322

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1427450535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2808",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838352808",
            "telephone_number": "208-651-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 N STANFORD LN",
            "address_2": "101",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990195034",
            "telephone_number": "509-891-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN NELSON NP-C, DBA, BALANCED WELLNESS MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-651-3322"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "WA",
            "license": "AP60478189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1538314257",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candice M Isom, LMP
• J. Evans, DMD, P.S. (KiDDS Dental)
• Adam Jaccard, PHARMD
• Staci Wixom Jacobs, LMP
• Benjamin Wells Jaderholm, D.O.
• Jennifer Janzen, LMP
• JD Online LLC (Washington Medical Group)
• Ashley N Jefferson, BSN, RNC-OB, C-EFM
• Erin K Jennings, PHARMD
• Erin McKeever Jerde

• General Practice Physician in Liberty Lake, WA
• Providers in Liberty Lake, WA by specialty
• General Practice Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.