Individual
JENNIFER L NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
716 E 19TH ST, SIOUX FALLS, SD 57105
(605) 444-8650
(605) 444-8651
Mailing address
716 E 19TH ST, SIOUX FALLS, SD 57105
(605) 444-8650
(605) 444-8651
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
101467
MN
207Q00000X
Family Medicine Physician
47059
MN
207Q00000X
Family Medicine Physician
Primary
5496
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4993299
BLUE CROSS BLUE SHIELD
SD
05
—
5612862
—
SD
Enumeration date
06/01/2006
Last updated
10/27/2015
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