Provider Demographics
NPI:1891777306
Name:NELSON, KRISTEN M (NP)
Entity Type:Individual
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First Name:KRISTEN
Middle Name:M
Last Name:NELSON
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Gender:F
Credentials:NP
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Mailing Address - Street 1:1201 SEVEN LOCKS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2931
Mailing Address - Country:US
Mailing Address - Phone:301-652-5771
Mailing Address - Fax:301-652-6332
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:RM 4B42
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-877-7259
Practice Address - Fax:202-877-7258
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2010-06-08
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Provider Licenses
StateLicense IDTaxonomies
DCRN62342363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
011789W15Medicare PIN
P95057Medicare UPIN