Individual
JACALYN A NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2844 INDEX RD, FITCHBURG, WI 53713-3117
(608) 229-7979
(608) 229-8110
Mailing address
2844 INDEX RD, FITCHBURG, WI 53713-3117
(608) 229-7979
(608) 229-8110
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
49405-020
WI
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
49405-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063430833
—
WI
Enumeration date
07/18/2006
Last updated
10/27/2020
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