Provider Demographics
NPI:1073955472
Name:NELSON, VICTORIA R (FNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:R
Last Name:NELSON
Suffix:
Gender:F
Credentials:FNP
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Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:FROEDTERT & MEDICAL COLLEGE PRE-OP CLINIC
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6250
Mailing Address - Fax:414-805-7210
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:FROEDTERT & MEDICAL COLLEGE PRE-OP CLINIC
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6250
Practice Address - Fax:414-805-7210
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2023-04-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI170697-30363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1073955472Medicaid