Provider Demographics
NPI:1285838789
Name:NELSON, MARVIS LEE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MARVIS
Middle Name:LEE
Last Name:NELSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5353 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2906
Mailing Address - Country:US
Mailing Address - Phone:561-799-8136
Mailing Address - Fax:561-799-8691
Practice Address - Street 1:5353 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2906
Practice Address - Country:US
Practice Address - Phone:561-799-8136
Practice Address - Fax:561-799-8691
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL789862363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health