Provider Demographics
NPI:1598994618
Name:NELSON, JESSIE A (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:A
Last Name:NELSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:313 ARGOW DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-1105
Mailing Address - Country:US
Mailing Address - Phone:412-713-2731
Mailing Address - Fax:
Practice Address - Street 1:400 OXFORD DR STE 102
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2351
Practice Address - Country:US
Practice Address - Phone:412-374-1441
Practice Address - Fax:412-374-1443
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA053849363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical