Healthcare Provider Details

I. General information

NPI: 1982317624
Provider Name (Legal Business Name): NATALIE NELSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2022
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43658 CA-299
FALL RIVER MILLS CA
96028
US

IV. Provider business mailing address

43563 STATE HIGHWAY 299 E
FALL RIVER MILLS CA
96028-9787
US

V. Phone/Fax

Practice location:
  • Phone: 530-999-9020
  • Fax:
Mailing address:
  • Phone: 530-336-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95023131
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: