Provider Demographics
NPI:1376259499
Name:NELSON, PATRICIA ELAINE (RN)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ELAINE
Last Name:NELSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:ELAINE
Other - Last Name:BORDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:149 JULIUSTOWN RD.
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NJ
Mailing Address - Zip Code:08022
Mailing Address - Country:US
Mailing Address - Phone:856-296-7140
Mailing Address - Fax:
Practice Address - Street 1:WALGREENS
Practice Address - Street 2:505 W. BLACK HORSE PIKE
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232
Practice Address - Country:US
Practice Address - Phone:609-641-9356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26N011803600163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse