National Provider Identifier
Lisa Joan Nelson, PA
Lisa Joan Nelson, PA is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Penn Yan, NY and a listed phone number of (315) 536-2752.
Profile Overview
- NPI
- 1053065680
- Provider Type
- Individual
- Primary Specialty
- Medical Physician Assistant
- Enumeration Date
- February 11, 2022
- Last Updated
- January 19, 2024
Practice Location
- 112 Kimball Ave
- Penn Yan, NY 14527-1816
Phone: (315) 536-2752
Mailing Address
- 601B W Washington St
- Geneva, NY 14456-2119
Specialties
- Medical Physician Assistant (363AM0700X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1053065680
- Entity Type
- Individual
- Last Name
- Nelson
- First Name
- Lisa
- Middle Name
- Joan
- Credential
- PA
- Mailing Street Address
- 601B W Washington St
- Mailing City
- Geneva
- Mailing State
- NY
- Mailing ZIP Code
- 14456-2119
- Mailing Country
- US
- Mailing Phone
- (315) 787-8151
- Practice Street Address
- 112 Kimball Ave
- Practice City
- Penn Yan
- Practice State
- NY
- Practice ZIP Code
- 14527-1816
- Practice Country
- US
- Practice Phone
- (315) 536-2752
- Enumeration Date
- February 11, 2022
- Last Updated
- January 19, 2024
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- January 19, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Medical Physician Assistant (363AM0700X), Student in an Organized Health Care Education/Training Program (390200000X)