Individual
JERI LYNN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW-PIP
Contact information
Practice address
2412 S CLIFF AVE, SUITE 200, SIOUX FALLS, SD 57105-4031
(605) 322-4079
Mailing address
PO BOX 5045, ATTN: P.F.S. PROV ENROLLMENT, SIOUX FALLS, SD 57117-5045
(605) 322-6400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1513
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740575240
BCBS MN
—
05
—
1740575240
—
IA
05
—
1740575240
—
MN
05
—
2002867
—
SD
Enumeration date
06/13/2011
Last updated
01/09/2012
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