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General NPI Number Information
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NPI Number | 1346755840
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Entity Type | Individual
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Provider Name | MARY PAT NELSON PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/06/2017
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Last Update Date | 07/13/2025
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Provider Practice Location Address
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Address Line | 1100 W MALLON AVE
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City | SPOKANE
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State | WA
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Zip | 99260-3279
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Country | US
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Telephone | 509-477-2278
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Fax |
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Provider Business Mailing Address
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Address Line | 4709 LEADENHALL DR
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23234-5321
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Country | US
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Telephone | 804-307-1962
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 70018840
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001256707
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License Number State | VA
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