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General NPI Number Information
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NPI Number | 1811572290
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Entity Type | Individual
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Provider Name | ANTOINETTE ELIZABETH NELSON APRN
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Gender | Female
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Dates
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Enumeration Date | 03/16/2021
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 1270 PALM COAST PKWY NW
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City | PALM COAST
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State | FL
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Zip | 32137-4738
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Country | US
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Telephone | 386-225-4631
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 KERSFIELD CIR
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City | LAKE MARY
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State | FL
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Zip | 32746-1937
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Country | US
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Telephone | 407-620-7529
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11030330
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License Number State | FL
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