MEDICARE: AUTUMN 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
1	367A00000X	Advanced Practice Midwife	APRN1570	HI
2	367A00000X	Advanced Practice Midwife	MW010326	PA

General Provider Information

NPI Number	:	1386073450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUTUMN NELSON

Provider Business Mailing Address
First Line	:	918 COUNTY LINE RD
Second Line	:
City	:	BRYN MAWR
State	:	PA
Zip	:	19010-2502
Country	:	US
Telephone Number	:	610-525-6090
Fax Number	:	610-525-6631

Provider Business Practice Location Address
First Line	:	6837 GERMANTOWN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-2113
Country	:	US
Telephone Number	:	267-297-7055
Fax Number	:	484-244-7087

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2013
Last Update Date	:	01/10/2026

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Directions to “ AUTUMN NELSON ” Practice Location

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