Provider Demographics
NPI:1851839203
Name:NELSON, NICOLE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 MOCKINGBIRD CT STE B
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-7511
Mailing Address - Country:US
Mailing Address - Phone:256-320-7781
Mailing Address - Fax:256-320-7776
Practice Address - Street 1:1609 MOCKINGBIRD CT
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-7510
Practice Address - Country:US
Practice Address - Phone:256-320-7781
Practice Address - Fax:256-320-7776
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-123486363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology