Provider Demographics
NPI:1245470095
Name:NELSON, DEBRA KAYE (WHNP)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:KAYE
Last Name:NELSON
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18220 STATE HIGHWAY 249 STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4370
Mailing Address - Country:US
Mailing Address - Phone:281-890-4448
Mailing Address - Fax:281-890-4237
Practice Address - Street 1:18220 STATE HIGHWAY 249 STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070
Practice Address - Country:US
Practice Address - Phone:281-890-4448
Practice Address - Fax:281-890-4237
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX559134363L00000X
TXAP110119363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203419102Medicaid
TX203419103Medicaid
TX8386NWOtherBLUE CROSS BLUE SHIELD
TX203419103Medicaid
TX8386NWOtherBLUE CROSS BLUE SHIELD