Individual
CAMERON LEWIS NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1553 E CENTER ST, POCATELLO, ID 83201-4135
(208) 233-9355
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1799
(208) 785-4100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-1556
ID
363AM0700X
Medical Physician Assistant
Primary
PA-1556
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01159224
—
CO
Enumeration date
08/07/2011
Last updated
06/16/2025
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