Provider Demographics
NPI:1669228599
Name:NELSEN, THOMAS JON (PA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JON
Last Name:NELSEN
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:2800 ASHTON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2486
Mailing Address - Country:US
Mailing Address - Phone:910-799-2262
Mailing Address - Fax:910-799-2943
Practice Address - Street 1:2800 ASHTON DR STE 200
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2486
Practice Address - Country:US
Practice Address - Phone:910-799-2262
Practice Address - Fax:910-799-2943
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2025-02-12
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant