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NPI Code Detail

MEDICARE: MEGAN NICOLE NELSON

MEDICARE: MEGAN NICOLE NELSON
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1811715907
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN NICOLE NELSON
Provider Business Mailing Address
First Line : 60 N 36TH ST FL 11
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-5639
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 60 N 36TH ST FL 11
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-5639
Country : US
Telephone Number : 267-359-5741
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2024
Last Update Date : 09/28/2024

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Directions to “ MEGAN NICOLE NELSON ” Practice Location

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