Provider Demographics
NPI:1679526420
Name:NELSON, MARTHA C (PAC)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:C
Last Name:NELSON
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
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Mailing Address - Street 1:451 RUIN CREEK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-2878
Mailing Address - Country:US
Mailing Address - Phone:252-492-9565
Mailing Address - Fax:252-492-5373
Practice Address - Street 1:451 RUIN CREEK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2878
Practice Address - Country:US
Practice Address - Phone:252-492-9565
Practice Address - Fax:252-492-5373
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC103639363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant