Individual
MR. NICHOLAS JEREMY NELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1721 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 23511-2899
(757) 444-5511
Mailing address
1721 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 23511-2899
(757) 444-5511
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/21/2006
Last updated
06/08/2009
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