Individual
MARVA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11642 171ST ST, JAMAICA, NY 11434-1824
(347) 954-8649
Mailing address
11642 171ST ST, JAMAICA, NY 11434-1824
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
533105
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
533105
NY
Other
Enumeration date
09/22/2025
Last updated
04/15/2026
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