MRS. AUDREY RAQUEL NELSON


Address: 901 Hemphill St, Fort Worth, TX 76104-3111
Phone: 8173324060

MRS. AUDREY RAQUEL NELSON (NPI# 1003961202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003961202
Entity Type Individual
Full Name MRS. AUDREY RAQUEL NELSON
Other Name MS. AUDREY CUSTODIO
Credential PA
Practice Address 901 Hemphill St
Fort Worth
TX 76104-3111
Mailing Address P.o. Box 961205
Fort Worth
TX 76161-1205
Practice Telephone 8173324060
Practice Fax Number 8173322304
Mailing Telephone 8177408400
Mailing Fax Number 8173783699
Enumeration Date 2007-01-25
Last Update Date 2016-06-10
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant PA10397 TX Physician Assistants & Advanced Practice Nursing Providers

Other Providers AUDREY NELSON

NPI Name Taxonomy Address Enumeration
1972903094 Audrey Nelson Speech-Language Pathologist 810 Poinsetta Dr Apt 10, Indian Harbour Beach, FL 32937-3551 2014-08-26
1639329279 Audrey May Nelson Internal Medicine 2105 Valkyrie Dr Nw, Rochester, MN 55901-8117 2008-09-19
1730680679 Audrey Nelson Registered Nurse 6321 New Utrecht Ave, Brooklyn, NY 11219-5425 2018-02-26
1447688320 Audrey Nelson Social Worker 1001 S Raisinville Rd, Monroe, MI 48161-9754 2013-10-31
1841478179 Audrey L Nelson Registered Nurse 11605 N Nebraska Ave, Tampa, FL 33612-5738 2008-02-08

Office Location

Street Address 901 HEMPHILL ST
City FORT WORTH
State TX
Zip Code 76104-3111

Providers in the same location

NPI Name Taxonomy Address Enumeration
1609821149 Philip F Anthony Otolaryngology 901 Hemphill St, Fort Worth, TX 76104-3111 2006-05-23

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1669082186 Cvs Pharmacy, Inc. Durable Medical Equipment & Medical Supplies 1115 8th St, Fort Worth, TX 76104 2020-08-10
1992343693 Iris Giove Psychologist John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 2019-12-13
1104480656 Swarnalaxmi Umapathy Student in an Organized Health Care Education/Training Program 900 8th Avenue, Fort Worth, TX 76104 2019-04-30
1881189132 Mega Surgical Assistants LLC Specialist/Technologist, Other 1301pennsylvania, Fort Worth, TX 76104 2018-06-28
1356848899 Tricia Kelly Nurse Practitioner 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 2018-04-11
1952820979 Modern Vein Clinic Internal Medicine 757 8th Avenue, Suite A, Forth Worth, TX 76104 2017-09-11
1790207165 Vanessa Abbood Dietitian, Registered 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 2017-07-07
1922537562 Nicole Marie Tod Student in an Organized Health Care Education/Training Program 1500 S Main Street, Fort Worth, TX 76104 2017-06-07
1770025934 Micah Bonola Chiropractor 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 2016-11-04
1518315894 United Bioscience, LLC. Clinical Medical Laboratory 901 W. Leuda St., B, Fort Worth, TX 76104 2016-05-27
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1811596927 Emily Lau Physician Assistant 3848 N Tarrant Pkwy Ste 120, Fort Worth, TX 76244-5422 2020-10-20
1629681952 Anum Bashwani Physician Assistant 5601 Bridge St Ste 450, Fort Worth, TX 76112-2305 2020-08-26
1780200881 Emily Brown Holloway Physician Assistant 1904 Turner Ridge Dr Apt 5202, Fort Worth, TX 76110-2499 2020-06-24
1679196570 Maria Cristela Mosso Physician Assistant 4521 S Hulen St Ste 118, Fort Worth, TX 76109-4954 2020-05-26
1679195978 Jacob Torre Physician Assistant 1701 River Run Ste 1118, Fort Worth, TX 76107-6557 2020-05-11
1871122382 Kenaud Jeune Physician Assistant 5817 Fairglen Ave Apt 312, Fort Worth, TX 76137-6810 2020-04-06
1922635648 Lauren Elizabeth Studey Physician Assistant 3470 Sagecrest Ter, Fort Worth, TX 76109-2555 2020-03-24
1033743612 James Bregg Reedy Physician Assistant 200 W Magnolia Ave Ste 201, Fort Worth, TX 76104-7657 2020-02-24
1992335194 Alexandria Christine Rios Physician Assistant 5904 Rockhill Rd, Fort Worth, TX 76112-3047 2020-01-16
1982253605 Kelly Ann Klein Physician Assistant 6708 River Bend Rd, Fort Worth, TX 76132-1108 2019-09-05
Find all providers in FORT WORTH

Competitor

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City FORT WORTH
Zip Code 76104

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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