Healthcare Provider Details

I. General information

NPI: 1073236717
Provider Name (Legal Business Name): ISABELA DOS SANTOS NELSON FNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ISABELA DOS SANTOS FNP, RN

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/19/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BLVD
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

240 NATOMA STATION DR APT 170
FOLSOM CA
95630-7985
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2011
  • Fax:
Mailing address:
  • Phone: 714-300-9754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95042533
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: