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NPI Code Detail

MEDICARE: CHRYSTAL ELIZABETH NELSON

MEDICARE: CHRYSTAL ELIZABETH NELSON
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
1225200000XPhysical Therapy AssistantPTA25134FL

General Provider Information

NPI Number : 1245001437
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRYSTAL ELIZABETH NELSON
Provider Business Mailing Address
First Line : 8851 WASHINGTON AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32208-2686
Country : US
Telephone Number : 904-537-2170
Fax Number :
Provider Business Practice Location Address
First Line : 12740 LANIER RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32226-1704
Country : US
Telephone Number : 904-537-2170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2024
Last Update Date : 01/16/2024

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Directions to “ CHRYSTAL ELIZABETH NELSON ” Practice Location

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