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General NPI Number Information
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NPI Number | 1154670412
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Entity Type | Individual
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Provider Name | MARIE Y NELSON NP
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Gender | Female
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Dates
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Enumeration Date | 09/02/2012
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 912 S MAIN ST
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City | PLEASANTVILLE
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State | NJ
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Zip | 08232-3618
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Country | US
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Telephone | 609-445-4926
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Fax | 609-380-4795
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Provider Business Mailing Address
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Address Line | 912 S MAIN ST
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City | PLEASANTVILLE
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State | NJ
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Zip | 08232-3618
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Country | US
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Telephone | 609-445-4926
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Fax | 609-380-4795
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00393400
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License Number State | NJ
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