Individual
CHRISTINE LEISHMAN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSW
Contact information
Practice address
75-5751 KUAKINI HWY STE 101A, KAILUA KONA, HI 96740-1705
(808) 326-5629
Mailing address
75-5751 KUAKINI HWY STE 203, KAILUA KONA, HI 96740-1753
(808) 326-5629
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2022013877
MO
363A00000X
Physician Assistant
281934-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
281934-3503
STATE LICENSE
UT
01
—
NELSOC
SBHC STAFF CODE
UT
Enumeration date
05/22/2007
Last updated
09/10/2025
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