Individual
DR. JARROD ALLEN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5366 386TH ST NE, NORTH BRANCH, MN 55056-5833
(651) 674-6844
Mailing address
1479 485TH ST W, STANCHFIELD, MN 55080-4216
(763) 691-8252
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2410
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
159371
EYEMED
MN
01
—
22-02649
MEDICA
MN
05
—
552025800
—
MN
01
—
817S9NE
BLUE CROSS BLUE SHIELD
MN
01
—
916771028513
PREFERRED ONE
MN
01
—
HP28522
HEALTH PARTNERS
MN
Enumeration date
03/08/2007
Last updated
01/05/2024
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