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Individual

MALLORY MARY NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2 SHIRCLIFF WAY BLDG SUITE635, JACKSONVILLE, FL 32204-4753
(904) 922-4009
Mailing address
75436 BANYAN WAY, YULEE, FL 32097-0231
(404) 797-9949

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9862
GA

Other

Enumeration date
07/29/2020
Last updated
01/29/2025
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