Individual
DR. JILL NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
617 N JEFFERSON AVE, LEBANON, MO 65536-2745
(417) 532-2986
(417) 532-2271
Mailing address
627 S FOUNTAIN AVE, REPUBLIC, MO 65738-2177
(815) 588-1110
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038008152
IL
111N00000X
Chiropractor
Primary
2022024301
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528044278
NPI
IL
01
—
9921349
BCBS
IL
Enumeration date
12/15/2005
Last updated
04/02/2024
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