Individual
CHRISTINE LEISHMAN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSW
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
Update your record
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