Individual
JEREMIAH ALLEN NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 414-8713
Mailing address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 414-8713
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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