Individual
JERRIE LYNN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICAC
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
142
MT
171100000X
Acupuncturist
123
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0089138
BCBS
MT
Enumeration date
11/28/2006
Last updated
09/11/2025
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