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Individual

JENNIFER NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
515 FOX RUN CIR, COLORADO SPRINGS, CO 80921-3032
(719) 271-4317
Mailing address
515 FOX RUN CIR, COLORADO SPRINGS, CO 80921-3032
(719) 271-4317

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
385HR2065X
Child Physical Disabilities Respite Care
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
99986361
CO
Enumeration date
04/12/2016
Last updated
04/12/2016
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