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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PENELOPE IVY NELSON, LADC

Active Sole Proprietor

PENELOPE IVY NELSON, LADC is a Addiction (Substance Use Disorder) Counselor healthcare provider located in WINNEBAGO, Minnesota. NPI 1710640032 is currently active in the NPPES registry. Verify at CMS.

Addiction (Substance Use Disorder) Counselor · WINNEBAGO, MN

Registration Details

NPI Number
1710640032
Provider Type
Individual
Gender
Female
NPI Issued
Oct 14, 2021 (4.8158378988616 yrs)
Last Updated
Oct 14, 2021
License
305553 (MN)
Sole Proprietor
Yes

Practice Information

Address
132 1ST AVE SE
WINNEBAGO, MN, 560981052
Browse MN providers · Browse ZIP 56098
Phone
6128770276
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.