Provider Demographics
NPI:1336322874
Name:NELSON, TERI L (PAC)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:L
Last Name:NELSON
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:1145 BEACON AVE
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2471
Mailing Address - Country:US
Mailing Address - Phone:609-597-7110
Mailing Address - Fax:609-597-7113
Practice Address - Street 1:1145 BEACON AVE
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2471
Practice Address - Country:US
Practice Address - Phone:609-597-7110
Practice Address - Fax:609-597-7113
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2023-11-22
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant