| NPI | 1265100903 |
|---|---|
| Former Name | NICOLE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 321912) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN200834) |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2025-03-31 |