MEDICARE: MS. CHRISTINA MARJORIE NELSON CFNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R16084	NM
2	363LF0000X	Family Nurse Practitioner	265149	CA

General Provider Information

NPI Number	:	1750369484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA MARJORIE NELSON CFNP

Provider Business Mailing Address
First Line	:	6638 SAINT ESTABAN ST
Second Line	:
City	:	TUJUNGA
State	:	CA
Zip	:	91042-3333
Country	:	US
Telephone Number	:	818-353-6103
Fax Number	:

Provider Business Practice Location Address
First Line	:	6638 SAINT ESTABAN ST
Second Line	:
City	:	TUJUNGA
State	:	CA
Zip	:	91042-3333
Country	:	US
Telephone Number	:	818-353-6103
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	05/02/2012

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