Individual
DAVID WESLEY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
345 BLACKSTONE BLVD, PROVIDENCE, RI 02906-4829
(401) 455-6200
(401) 455-6689
Mailing address
455 TOLL GATE RD, PRC AND CREDENTIALING, WARWICK, RI 02886-2759
(401) 273-0641
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01074
RI
363AM0700X
Medical Physician Assistant
PA01074
RI
Other
Enumeration date
08/08/2018
Last updated
07/12/2024
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