Healthcare Provider Details

I. General information

NPI: 1750369484
Provider Name (Legal Business Name): CHRISTINA MARJORIE NELSON CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 05/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6638 SAINT ESTABAN ST
TUJUNGA CA
91042-3333
US

IV. Provider business mailing address

6638 SAINT ESTABAN ST
TUJUNGA CA
91042-3333
US

V. Phone/Fax

Practice location:
  • Phone: 818-353-6103
  • Fax:
Mailing address:
  • Phone: 818-353-6103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR16084
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number265149
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: