Provider Demographics
NPI:1598384554
Name:NELSON, JANET (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
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 1:51249 E COUNTY ROAD 1520
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:OK
Mailing Address - Zip Code:74872-8341
Mailing Address - Country:US
Mailing Address - Phone:660-973-6647
Mailing Address - Fax:
Practice Address - Street 1:1400 E COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4288
Practice Address - Country:US
Practice Address - Phone:918-423-1267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKF01200697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily