Individual
GRACE ISABELLA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-3535
(215) 590-3992
Mailing address
722 KENMARE RD, BALA CYNWYD, PA 19004-2110
(201) 704-8476
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
95012476
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
SP027380
PA
Other
Enumeration date
09/13/2019
Last updated
09/15/2023
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