Individual
JENNIFER K NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1997 SLOAN PL STE 17, MAPLEWOOD, MN 55117-2051
(651) 772-6251
(651) 224-9661
Mailing address
2854 HIGHWAY 55, SUITE 130, EAGAN, MN 55121-2156
(651) 842-3378
(651) 224-5273
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10980
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124309372
—
MN
Enumeration date
09/01/2011
Last updated
10/25/2022
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