Individual
DR. JERI A NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1300 SOUTH DR., WINNEBAGO, WI 54985-0009
(920) 235-4910
(920) 236-2931
Mailing address
1300 SOUTH DR., WINNEBAGO, WI 54985-0009
(920) 235-4910
(920) 236-2931
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
21057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21057
LICENSE NUMBER
WI
05
—
30114800
—
WI
Enumeration date
12/15/2006
Last updated
03/07/2023
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