Bradley Eugene Nelson
Nurse Practitioner - Gerontology
622 W 168th St
New York
, New York 10032-3720
Bradley Eugene Nelson
Nurse Practitioner - Gerontology
622 W 168th St
New York
, New York 10032-3720
(763) 544-0696
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Bradley Eugene Nelson
- 6200 Shingle Creek Pkwy Ste 250
- Brooklyn Center, MN
- Zip : 55430-2107
- Fax : (763) 544-0696
- Phone : (763) 544-0696
Second Address
- Bradley Eugene Nelson
- 622 W 168th St
- New York, NY
- Zip : 10032-3720
- Phone : (212) 305-3273
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | F307678 | NY |
National Provider Identifier
| NPI | 1083008924 |
|---|---|
| Provider Name | Bradley Eugene Nelson |
| First Address | Brooklyn Center, MN 55430-2107 |
| Second Address | New York, NY 10032-3720 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/03/2015 |
| Last Update Date | 09/02/2022 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.