Provider Demographics
NPI:1669684395
Name:NELSON, NYNA J (RN-CS, FNP, GNP)
Entity Type:Individual
Prefix:MS
First Name:NYNA
Middle Name:J
Last Name:NELSON
Suffix:
Gender:F
Credentials:RN-CS, FNP, GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 NATOMA ST STE 110
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-2658
Mailing Address - Country:US
Mailing Address - Phone:916-294-0300
Mailing Address - Fax:916-294-0324
Practice Address - Street 1:31 NATOMA ST STE 110
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-2658
Practice Address - Country:US
Practice Address - Phone:916-294-0300
Practice Address - Fax:916-294-0324
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG332328363LF0000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Not Answered363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology