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General NPI Number Information
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NPI Number | 1992005375
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Entity Type | Organization
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Legal Business Name | NELSON DERMATOLOGY, PLLC
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 13289 GATEWAY CENTER DR # 27
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City | GAINESVILLE
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State | VA
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Zip | 20155-2989
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Country | US
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Telephone | 703-373-9870
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Fax | 703-656-4777
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Provider Business Mailing Address
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Address Line | 7371 ATLAS WALK WAY # 645
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City | GAINESVILLE
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State | VA
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Zip | 20155-2992
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Country | US
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Telephone | 703-373-9870
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Fax | 703-656-4777
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNELL NELSON
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Credential | MD
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Telephone | 703-373-9870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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