Basic Information
Provider Information
NPI: 1104010859
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NELSON
FirstName: KRISTEN
MiddleName: FRANCES
NamePrefix:  
NameSuffix:  
Credential: FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 559 CLAY ST
Address2: SUITE 200
City: SAN FRANCISCO
State: CA
PostalCode: 941113029
CountryCode: US
TelephoneNumber: 4156445265
FaxNumber: 4152910489
Practice Location
Address1: 559 CLAY ST
Address2: SUITE 200
City: SAN FRANCISCO
State: CA
PostalCode: 941113029
CountryCode: US
TelephoneNumber: 4156445265
FaxNumber: 4152910489
Other Information
ProviderEnumerationDate: 09/05/2007
LastUpdateDate: 12/30/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X17436CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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