Provider Demographics
NPI:1558818864
Name:NELSON, ADAM (PA-C)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:NELSON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4100 LAKE OTIS PKWY STE 108
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5230
Mailing Address - Country:US
Mailing Address - Phone:907-563-3145
Mailing Address - Fax:833-464-5196
Practice Address - Street 1:4100 LAKE OTIS PKWY STE 108
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5230
Practice Address - Country:US
Practice Address - Phone:907-563-3145
Practice Address - Fax:833-464-5196
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2023-11-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant