Individual
MRS. JENNIFER WILES NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2850 LONE OAK RD, SUITE 4, PADUCAH, KY 42003-8043
(270) 554-3904
(270) 534-8928
Mailing address
2850 LONE OAK RD, SUITE 4, PADUCAH, KY 42003-8043
(270) 205-1394
(270) 534-8928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02847
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64068638
—
KY
Enumeration date
10/23/2006
Last updated
09/04/2024
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