Individual
MS. ABBY MARISSA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
12634 OLIVE BLVD, DEPT ORTHOPAEDIC SURGERY, SAINT LOUIS, MO 63141-6337
(314) 996-8099
(314) 996-8132
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 996-8099
(314) 996-8132
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2019006015
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220072978
—
MO
Enumeration date
02/11/2019
Last updated
04/17/2025
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