Provider Demographics
NPI:1073236717
Name:NELSON, ISABELA DOS SANTOS (FNP, RN)
Entity Type:Individual
Prefix:
First Name:ISABELA
Middle Name:DOS SANTOS
Last Name:NELSON
Suffix:
Gender:F
Credentials:FNP, RN
Other - Prefix:
Other - First Name:ISABELA
Other - Middle Name:
Other - Last Name:DOS SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP, RN
Mailing Address - Street 1:240 NATOMA STATION DR APT 170
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-7985
Mailing Address - Country:US
Mailing Address - Phone:714-300-9754
Mailing Address - Fax:
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-734-2011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95042533363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty