Individual
JODY RUTH SIMS NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-1000
Mailing address
5435 FELTL RD, MINNETONKA, MN 55343-7983
(952) 835-9880
(952) 857-1554
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
44031
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097320300
—
MN
01
—
44031
MEDICAL LICENSE
MN
Enumeration date
03/07/2006
Last updated
07/21/2022
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