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Individual

ELIZABETH ALICE NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
123 HOSPITAL DR STE 1008, WATERTOWN, WI 53098-3320
(920) 206-6500
Mailing address
18444 N 25TH AVE STE 310, PHOENIX, AZ 85023-1266
(866) 974-2673
(866) 939-2673

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5149-23
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10014061
WI
Enumeration date
03/03/2020
Last updated
10/07/2025
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