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General NPI Number Information
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NPI Number | 1609640531
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Entity Type | Individual
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Provider Name | CHRISTINA NELSON
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Gender | Female
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 1 BALA AVE STE LL3
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City | BALA CYNWYD
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State | PA
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Zip | 19004-3218
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Country | US
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Telephone | 484-892-7774
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Fax |
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Provider Business Mailing Address
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Address Line | 336 HAWARDEN RD
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City | SPRINGFIELD
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State | PA
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Zip | 19064-2604
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Country | US
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Telephone | 484-844-0682
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP029793
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License Number State | PA
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