Individual
KRISTA WERT NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA, MPH
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1401
(321) 434-1667
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1401
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9108801
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9108801
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015511600
—
FL
01
—
IG696Y
MEDICARE
FL
Enumeration date
06/30/2015
Last updated
11/12/2025
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