Individual
JENESIS JADAYAH NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2107 PIKE ST, POPLAR BLUFF, MO 63901-7008
(573) 714-1516
Mailing address
2107 PIKE ST, POPLAR BLUFF, MO 63901-7008
(573) 714-1516
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
1123849
TX
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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