Provider Demographics
NPI:1457492928
Name:NELSON, GINA VIRGINIA HERMSEN (RN,CPNP)
Entity Type:Individual
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First Name:GINA
Middle Name:VIRGINIA HERMSEN
Last Name:NELSON
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Gender:F
Credentials:RN,CPNP
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Mailing Address - Street 1:20 PROGRESS POINT PKWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-2206
Mailing Address - Country:US
Mailing Address - Phone:636-344-3333
Mailing Address - Fax:636-344-3334
Practice Address - Street 1:20 PROGRESS POINT PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-2206
Practice Address - Country:US
Practice Address - Phone:636-344-3333
Practice Address - Fax:636-344-3334
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2015-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2000161785363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics