Provider Demographics
NPI:1407204712
Name:NELSEN, BRITTANY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:
Last Name:NELSEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 SE 31ST ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-3438
Mailing Address - Country:US
Mailing Address - Phone:239-233-3092
Mailing Address - Fax:
Practice Address - Street 1:13 SE 21ST PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1437
Practice Address - Country:US
Practice Address - Phone:239-233-3092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9558103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical