Provider Demographics
NPI:1760422612
Name:NELSON, VIORIKA (DNP, FNP)
Entity Type:Individual
Prefix:DR
First Name:VIORIKA
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 WASON AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1132
Mailing Address - Country:US
Mailing Address - Phone:413-433-0828
Mailing Address - Fax:
Practice Address - Street 1:80 WASON AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1132
Practice Address - Country:US
Practice Address - Phone:413-794-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251170363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0701653Medicaid
MA1760422612OtherBMC HEALTHNET
MA2753249OtherCIGNA