Individual
JENNIFER NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7720 N FRESNO ST, FRESNO, CA 93720-2407
(559) 438-2300
Mailing address
3483 PONTIAC AVE, CLOVIS, CA 93619-7237
(559) 355-6816
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95009465
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95009465
NURSE PRACTITIONER
CA
Enumeration date
09/11/2018
Last updated
09/11/2018
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