Nelson was born in Chesterfield County, Virginia. His father, James died when he was 5 years old. He was an attorney in Chesterfield and Cumberland County, Virginia until about 1808 when he moved to Giles County, Tennessee at the time it was first opened for settlement. He was an early leader there in the town of Pulaski, serving on local committees, operating various business enterprises, and speculating in real estate. He was a friend on Andrew Jackson and president of the Jackson Society in Nashville, which promoted his candidacy for president. He was also friends with Sam Houston, and Nelson, son James Patteson, and Sam Houston were officer of the Texas Assocation, which worked to get a huge grant of land in Texas from the Mexican government, one that became Robertson's colony and covered 19 counties in Texas.

He was buried in the family cemetery on the Patteson homestead about a mile east of town. When the cemetery deteriorated, a local historical group had the stones and the large obelisk listing the family members buried in the family cemetery moved to Maplewood Cemetery, although the bodies were not moved. The obelisk was likely placed some years after his death. The Patteson family cemetery monument in Pulaski is a four-sided obelisk that lists Nelson and Rebecca Patteson and many of their descendants on the four sides. The monument lists Nelson's death date as March 4, 1824, a date that has appears to have been almost universally accepted by family researchers. However, evidence that appears difficult to refute indicates that he did not die until the spring of 1828. Chancery Court records in Giles County in November of 1827 show the settlement of the estate of Rebecca Markham Patteson, and indicate that her husband, Nelson, is the settlor. Nelson continues to appear in numerous public documents, meetings and correspondence in Pulaski and in Nashville numerous times from 1824 to 1828, also indicating the probable date error on the monument.