1477313898 NPI number — ACTON HEALTHCARE CONSULTANTS PLLC

Table of content: KYLE ALLEN NELSON MPH, ATC (NPI 1801925227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477313898 NPI number — ACTON HEALTHCARE CONSULTANTS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACTON HEALTHCARE CONSULTANTS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477313898
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5394
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRANBURY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76049-0394
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-578-1968
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
405 N RIDGEWAY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEBURNE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76033-5128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-578-1968
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2024

Additional Information

Authorized Official

Authorized Official Last Name:
BISHOP
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
817-578-1968

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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