Individual
BERNADETTE N. NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, PMHNP
Contact information
Practice address
1400 PELHAM PARKWAY SOUTH, JACOBI MEDICAL CENTER, BRONX, NY 10461
(718) 918-5000
Mailing address
8011 AVENUE K, BROOKLYN, NY 11236-4201
(561) 628-2860
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP9209602
FL
363LF0000X
Family Nurse Practitioner
Primary
F333417
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306640100
—
NY
01
—
Y064G
MEDICARE ID UNSPECIFIED
NY
01
—
Y064X
MEDICARE ID UNSPECIFIED
NY
01
—
Y064Y
MEDICARE ID UNSPECIFIED
NY
Enumeration date
02/22/2006
Last updated
11/19/2011
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