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Individual

JAN NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
185 DEVONSHIRE ST STE 901, BOSTON, MA 02110-1485
(617) 259-1895
Mailing address
147 JERSEY ST, MARBLEHEAD, MA 01945-1346
(781) 910-4598

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
074799-21
NH
163W00000X
Registered Nurse
RN2284986
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
074799-23
NH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
11002628
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2284986
MA

Other

Enumeration date
11/29/2016
Last updated
09/21/2020
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