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Individual

MRS. JANESSA CAPRI NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A1C, MBA

Contact information

Practice address
210 N DADE AVE, FERGUSON, MO 63135-1825
(314) 495-0117
(314) 521-3428
Mailing address
PO BOX 35135, FERGUSON, MO 63135-0635
(314) 495-0117
(314) 521-3428

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
3747P1801X
Personal Care Attendant
Primary

Other

Enumeration date
06/13/2011
Last updated
10/26/2011
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