Healthcare Provider Details

I. General information

NPI: 1679226815
Provider Name (Legal Business Name): KRISTY GAIL NELSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2022
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 ACADEMY RD NE # 104
ALBUQUERQUE NM
87109-3379
US

IV. Provider business mailing address

2616 SMITH MAREK RD
SCHULENBURG TX
78956-5017
US

V. Phone/Fax

Practice location:
  • Phone: 505-730-5020
  • Fax:
Mailing address:
  • Phone: 979-743-9702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1060135
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number88599
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number88599
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: