Provider Demographics
NPI:1508465121
Name:NELSON, WHITNEY BROOKE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:BROOKE
Last Name:NELSON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 HALF LN
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-7974
Mailing Address - Country:US
Mailing Address - Phone:606-263-0110
Mailing Address - Fax:
Practice Address - Street 1:842 E MOUNTAIN PKWY
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465-8378
Practice Address - Country:US
Practice Address - Phone:606-349-8100
Practice Address - Fax:606-349-8150
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1140646163W00000X
KY3015450363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner