Provider Demographics
NPI:1780219618
Name:NELSON, MEAGHAN ELIZABETH (PA)
Entity Type:Individual
Prefix:MS
First Name:MEAGHAN
Middle Name:ELIZABETH
Last Name:NELSON
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Gender:F
Credentials:PA
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-316-5800
Mailing Address - Fax:757-534-5190
Practice Address - Street 1:6259 W EMERALD ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8731
Practice Address - Country:US
Practice Address - Phone:208-489-1900
Practice Address - Fax:208-375-5286
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2024-01-24
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Provider Licenses
StateLicense IDTaxonomies
VA01100006859363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant