Individual
KERRIN M NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10201 66TH RD, FOREST HILLS, NY 11375-2029
(718) 830-4000
Mailing address
2439 84TH ST, EAST ELMHURST, NY 11370-1604
(347) 432-4070
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
720493
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F403414-01
NY
Other
Enumeration date
10/14/2020
Last updated
04/01/2021
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