Provider Demographics
NPI:1821029315
Name:NELSON, GAIL A (APRN)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:A
Last Name:NELSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9346
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-0346
Mailing Address - Country:US
Mailing Address - Phone:801-281-3188
Mailing Address - Fax:801-314-4433
Practice Address - Street 1:5770 S 250 E
Practice Address - Street 2:COTTONWOOD MEDICAL TOWERS #330
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-8100
Practice Address - Country:US
Practice Address - Phone:801-281-3188
Practice Address - Fax:801-314-4433
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1933134405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner