Provider Demographics
NPI:1912951765
Name:NELSON, ERIC CHRISTIAN (ARNP)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:CHRISTIAN
Last Name:NELSON
Suffix:
Gender:M
Credentials:ARNP
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 1208
Mailing Address - Street 2:
Mailing Address - City:PORT HADLOCK
Mailing Address - State:WA
Mailing Address - Zip Code:98339-1208
Mailing Address - Country:US
Mailing Address - Phone:360-379-6737
Mailing Address - Fax:360-379-6518
Practice Address - Street 1:121 OAK BAY RD
Practice Address - Street 2:
Practice Address - City:PORT HADLOCK
Practice Address - State:WA
Practice Address - Zip Code:98339
Practice Address - Country:US
Practice Address - Phone:360-379-6737
Practice Address - Fax:360-379-6518
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30000054363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner