Provider Demographics
NPI:1588290068
Name:NELSON, KATHRYN E (MSN, APN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:NELSON
Suffix:
Gender:F
Credentials:MSN, APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 MARLTON PIKE E STE 1
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2207
Mailing Address - Country:US
Mailing Address - Phone:856-433-8265
Mailing Address - Fax:856-375-2219
Practice Address - Street 1:1401 MARLTON PIKE E STE 1
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2207
Practice Address - Country:US
Practice Address - Phone:856-433-8265
Practice Address - Fax:856-375-2219
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00981300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily