Provider Demographics
NPI:1548639313
Name:NELSON, ARACELI (CNM)
Entity type:Individual
Prefix:
First Name:ARACELI
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:CNM
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 7096
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0096
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:751 W. LEGION RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-7755
Practice Address - Country:US
Practice Address - Phone:209-956-7725
Practice Address - Fax:760-351-3770
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235752176B00000X, 367A00000X
CA363LW0102X363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health