Provider Demographics
NPI:1497794762
Name:NELSON, JON E (PA)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:E
Last Name:NELSON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:3200 BAILEY LN STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-8523
Mailing Address - Country:US
Mailing Address - Phone:239-262-1721
Mailing Address - Fax:239-262-1045
Practice Address - Street 1:3200 BAILEY LN STE 200
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-8523
Practice Address - Country:US
Practice Address - Phone:239-262-1721
Practice Address - Fax:239-262-1045
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9101901363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical