| Doctor Name: | MRS. WANDA JEAN NELSON |
| NPI Number: | 1801008743 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | AP30005582 |
| Business Practice Address: | 133 S College Ave Suite 101 College Place, WA - 993241193 |
| Business Phone Number: | 5095272425 |
| Business Fax Number: | |
| Mailing Address: | 133 S. College Ave, Suite 101 COLLEGE PLACE |
| State: | WA |
| Postal Code: | 99324 |
| Phone Number: | 5095272425 |
| Fax Number: | |
| NPI Enumeration Date: | 05/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP30005582 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |