Pamela Jayne Nelson

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704153516 Issued in MI

Practice address

100 Cherry St SE
Grand Rapids, MI 49503-4526

Phone

(616) 965-8253

NPI assigned

Jul 23, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1962989061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 ALMA ST",
            "city": "SPARTA",
            "state": "MI",
            "postal_code": "493451146",
            "telephone_number": "231-286-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHERRY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034526",
            "telephone_number": "616-965-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "PAMELA",
        "middle_name": "JAYNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704153516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSING",
            "identifier": "4704153516",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Alan Nelson, PA-C
• Kenneth Nelson, M.D.
• Lauren Ann Nelson, L.AC, LMT
• Matthew James Nelson, M.D.
• Meghan Nelson, LLMSW
• Patrick A Nelson
• Rebecca Elaine Nelson, LMSW
• Samuel Nelson, MD
• Sara Nelson, RN
• Sara Nelson

• Registered Nurse in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.