Individual
DR. JEROM NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
673
NM
152W00000X
Optometrist
ODP-100286
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/18/2013
Last updated
07/22/2016
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