Provider Demographics
NPI:1225686611
Name:NELSON, BRITTNEY NICHOLE (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:NICHOLE
Last Name:NELSON
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2501 E SOUTHERN AVE STE 23
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7667
Mailing Address - Country:US
Mailing Address - Phone:623-299-8799
Mailing Address - Fax:
Practice Address - Street 1:2501 E SOUTHERN AVE STE 23
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7667
Practice Address - Country:US
Practice Address - Phone:623-299-8799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9009363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant