Individual
MRS. JACALYN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
705 NORTHLAND DR, PRINCETON, MN 55371-2168
(763) 389-3111
(763) 389-1621
Mailing address
10400 KADLER AVE NE, MONTICELLO, MN 55362-8165
(763) 389-3111
(763) 389-1621
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1160693
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132460000
—
MN
Enumeration date
05/19/2008
Last updated
05/19/2008
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