Active NPI
Kristen Marie Nelson, CNP, MSN
- Family Nurse Practitioner
- Broadview HTS, OH
National Provider Identifier
1447352406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN-301046
- Practice address
- 1215 Candlewick LN
Broadview HTS, OH 44147-3271 - Phone
- (330) 388-9077
- NPI assigned
- Sep 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN-301046 | OH | Primary |
Addresses
Primary practice location
1215 Candlewick LN
Broadview HTS, OH 44147-3271
Mailing address
1215 Candlewick LN
Broadview HTS, OH 44147-3271
Phone (330) 388-9077
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2696088 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN-301046 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Kidney Care, Inc. | Past | Accepting new patients | |
| Lifesource Health Center LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Nephrology Physician
- Rocky River, OH
- NPI 1902975824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628553600000",
"number": "1447352406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 CANDLEWICK LN",
"city": "BROADVIEW HTS",
"state": "OH",
"postal_code": "441473271",
"telephone_number": "330-388-9077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 CANDLEWICK LN",
"city": "BROADVIEW HTS",
"state": "OH",
"postal_code": "441473271",
"telephone_number": "330-388-9077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "KRISTEN",
"middle_name": "MARIE",
"credential": "CNP, MSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-01",
"last_updated": "2021-08-10",
"certification_date": "2021-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "RN-301046",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2696088",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Broadview HTS, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.