Individual
JONATHAN MICHAEL NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3873 N PARKVIEW DR, FAYETTEVILLE, AR 72703-6286
(479) 571-7070
Mailing address
317 S GILES AVE, GENTRY, AR 72734-9589
(479) 790-0431
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
R094770
AR
Other
Enumeration date
11/17/2017
Last updated
11/17/2017
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