Individual
JENNIFER K NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1478
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067947000
—
MN
01
—
710000115
MEDICARE RAILROAD
MN
05
—
ENROLLED
—
MN
Enumeration date
01/10/2006
Last updated
11/23/2010
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