Individual
MR. JEFFREY L NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
4901 N 4TH AVE, SIOUX FALLS, SD 57104-0444
(605) 373-4813
(605) 373-4866
Mailing address
4901 N 4TH AVE, SIOUX FALLS, SD 57104-0444
(605) 373-4813
(605) 373-4866
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4782
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4782
STATE OF SD BOP LICENSE
SD
Enumeration date
11/14/2007
Last updated
11/14/2007
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