Provider Demographics
NPI:1538595285
Name:NELSON, NADJA JOVON (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:NADJA
Middle Name:JOVON
Last Name:NELSON
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 S BURLESON BLVD
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-1878
Mailing Address - Country:US
Mailing Address - Phone:817-447-3001
Mailing Address - Fax:817-289-5699
Practice Address - Street 1:2915 S BURLESON BLVD
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-1878
Practice Address - Country:US
Practice Address - Phone:817-447-3001
Practice Address - Fax:817-289-5699
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX867214163W00000X
TXAP124395363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse