Individual
DR. JACQUELINE LEE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
29 BLACK COAL DR, FORT WASHAKIE, WY 82514-0128
(307) 332-7300
(307) 332-7464
Mailing address
29 BLACK COAL DR, FORT WASHAKIE, WY 82514-0128
(307) 332-7300
(307) 332-7464
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4681A
WY
Other
Enumeration date
11/17/2006
Last updated
11/17/2011
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