Individual provider Active NPI

Nellie Skillen, FNP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1649090457
Registry record updated May 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95031668 Issued in CA
Practice address
1762 Westwood Blvd Ste 300
Los Angeles, CA 90024-5641
Phone
(561) 422-4206
NPI assigned
Oct 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95031668 CA Primary

Addresses

Primary practice location

1762 Westwood Blvd Ste 300
Los Angeles, CA 90024-5641

Mailing address

2090 Palm Beach Lakes Blvd Ste 700
West Palm Beach, FL 33409-6508
Phone (561) 422-4206

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95038278CAMDNurse Practitioner
95031668CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Miguel Medical Clinic, Inc CurrentSince Apr 27, 2025 Accepting new patients

Locations

8204 Long Beach Blvd
#B
South Gate, CA 90280
Phone (323) 588-3300

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780185600000",
    "number": "1649090457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 PALM BEACH LAKES BLVD STE 700",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096508",
            "telephone_number": "561-422-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 WESTWOOD BLVD STE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245641",
            "telephone_number": "561-422-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKILLEN",
        "first_name": "NELLIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2026-05-31",
        "certification_date": "2026-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95031668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.