Healthcare Provider Details

I. General information

NPI: 1881018695
Provider Name (Legal Business Name): BRANDON SCOTT NELSON FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2014
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 4TH AVE SE
CEDAR RAPIDS IA
52403-2405
US

IV. Provider business mailing address

1002 4TH AVE SE
CEDAR RAPIDS IA
52403-2405
US

V. Phone/Fax

Practice location:
  • Phone: 319-298-2200
  • Fax:
Mailing address:
  • Phone: 319-298-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA191042
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: