Individual
MR. JOHN ANDREW NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
1500 S DOBSON RD STE 202, MESA, AZ 85202-4724
(866) 974-2673
(866) 974-2673
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
6722
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05732036
BLUE SHIELD GROUP NUMBERT
IL
01
—
068816
HEALTH ALLIANCE PROVIDER
—
01
—
085000447003
OSF HEALTH PLANS
—
01
—
37945
TIRCARE
—
01
—
661684
HEALTHLINK
—
01
—
IL0105
JOHN DEERE HEALTH PLANS
—
Enumeration date
09/08/2005
Last updated
09/26/2022
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