Provider Demographics
NPI:1467859249
Name:NELSON, AMBER (CRNP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 BUTLER PIKE UNIT 170
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1202
Mailing Address - Country:US
Mailing Address - Phone:484-381-0158
Mailing Address - Fax:
Practice Address - Street 1:3328 MORRELL AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1222
Practice Address - Country:US
Practice Address - Phone:215-632-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-23
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014528363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care