Provider Demographics
NPI:1326126186
Name:NELSON, MONICA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:WILKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1608 S J ST FL 5
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4930
Mailing Address - Country:US
Mailing Address - Phone:253-274-7505
Mailing Address - Fax:206-855-7697
Practice Address - Street 1:1608 S J ST FL 5
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4930
Practice Address - Country:US
Practice Address - Phone:253-274-7505
Practice Address - Fax:206-855-7697
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00086584163WN0800X, 163WR0006X
WAAP30003764363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2138480Medicaid
WA9643776Medicaid