Provider Demographics
NPI:1720411382
Name:NELSON, VERONICA B (APN-C)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:B
Last Name:NELSON
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501-2000
Mailing Address - Country:US
Mailing Address - Phone:973-345-9745
Mailing Address - Fax:973-278-9885
Practice Address - Street 1:295 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-2000
Practice Address - Country:US
Practice Address - Phone:973-345-9745
Practice Address - Fax:973-278-9885
Is Sole Proprietor?:No
Enumeration Date:2013-08-17
Last Update Date:2013-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00035600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily