Provider Demographics
NPI:1598658023
Name:NELSON, MAGGIE ANN (PA-S)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:ANN
Last Name:NELSON
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 SHANKS DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-2191
Mailing Address - Country:US
Mailing Address - Phone:806-994-0681
Mailing Address - Fax:
Practice Address - Street 1:1804 FM 168
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:TX
Practice Address - Zip Code:79063-4208
Practice Address - Country:US
Practice Address - Phone:806-994-0681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program