Provider Demographics
NPI:1134514771
Name:NELSON, PATIENCE ANN (CNM, WHNP)
Entity Type:Individual
Prefix:
First Name:PATIENCE
Middle Name:ANN
Last Name:NELSON
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 MARINERS ISLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94404-1558
Mailing Address - Country:US
Mailing Address - Phone:650-285-6927
Mailing Address - Fax:888-352-7383
Practice Address - Street 1:951 MARINERS ISLAND BLVD
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94404-1558
Practice Address - Country:US
Practice Address - Phone:650-285-6927
Practice Address - Fax:888-352-7383
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7754541-4405363LW0102X
UT77545414402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health