Individual
ALEXANDRA N NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
725 S WEBSTER AVE, GREEN BAY, WI 54301-3500
(920) 433-7995
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5440-23
WI
363A00000X
Physician Assistant
Primary
5601010487
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1182339
NATIONAL COMMISSION ON CERT OF PHYSICIAN ASSISTANTS
—
Enumeration date
05/13/2021
Last updated
11/21/2022
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