Provider Demographics
NPI:1922076801
Name:NELSON, NATALIE EVANS (NP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:EVANS
Last Name:NELSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11737 PARK FOREST CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7001
Mailing Address - Country:US
Mailing Address - Phone:804-527-4950
Mailing Address - Fax:
Practice Address - Street 1:7603 FOREST AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4937
Practice Address - Country:US
Practice Address - Phone:804-282-8005
Practice Address - Fax:804-288-0269
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166145363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily