Individual
JESSICA LAYNE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
NAVAJO ROUTE 7 AND NAVAJO ROUTE 12, FORT DEFIANCE, AZ 86504
(928) 729-8325
Mailing address
PO BOX 1836, FORT DEFIANCE, AZ 86504-1836
(520) 979-6043
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP442493
PA
Other
Enumeration date
04/30/2008
Last updated
04/30/2008
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