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General NPI Number Information
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NPI Number | 1336114453
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Entity Type | Individual
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Provider Name | BERNADETTE N. NELSON FNP-BC, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 11/19/2011
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Provider Practice Location Address
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Address Line | 1400 PELHAM PARKWAY SOUTH JACOBI MEDICAL CENTER
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City | BRONX
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State | NY
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Zip | 10461
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Country | US
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Telephone | 718-918-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 8011 AVENUE K
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City | BROOKLYN
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State | NY
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Zip | 11236-4201
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Country | US
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Telephone | 561-628-2860
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9209602
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F333417
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License Number State | NY
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