Healthcare Provider Details

I. General information

NPI: 1164171971
Provider Name (Legal Business Name): CLAIRE SYLVIA NELSON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2022
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 GREENVIEW DR STE 485
STATE COLLEGE PA
16803-2106
US

IV. Provider business mailing address

155 WELLNESS WAY
STATE COLLEGE PA
16803-6702
US

V. Phone/Fax

Practice location:
  • Phone: 814-278-4898
  • Fax: 814-231-2004
Mailing address:
  • Phone: 814-231-7000
  • Fax: 814-231-7098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS025043
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: