Individual
MICHAEL C NELMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFNP
Contact information
Practice address
104 BURNEY DR, FLOWOOD, MS 39232-6621
(601) 987-8200
(601) 987-8211
Mailing address
PO BOX 30594, CHARLOTTE, NC 28230-0594
(601) 987-8200
(601) 987-8211
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
R875560
MS
363LF0000X
Family Nurse Practitioner
Primary
R875560
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03825391
—
MS
01
—
R875560
FNP LICENSE
MS
Enumeration date
10/27/2006
Last updated
09/08/2019
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