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NPI Code Detail

MEDICARE: MS. NICOLE ANNE NELSON MSN, APRN, FNP-BC

MEDICARE: MS. NICOLE ANNE NELSON MSN, APRN, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPRN002489NV

General Provider Information

NPI Number : 1104354810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICOLE ANNE NELSON MSN, APRN, FNP-BC
Provider Business Mailing Address
First Line : 2717 SIDONIA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-4262
Country : US
Telephone Number : 702-569-3068
Fax Number :
Provider Business Practice Location Address
First Line : 376 E WARM SPRINGS RD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-4241
Country : US
Telephone Number : 702-848-4443
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2017
Last Update Date : 09/03/2024

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