Individual
JACQUELYN JO NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CDE
Contact information
Practice address
1101 OAKRIDGE DRIVE, SUITE B, FORT COLLINS, CO 80525
(970) 622-9997
(970) 667-8383
Mailing address
1907 HILLROSE DRIVE, LOVELAND, CO 80538
(970) 622-9997
(970) 667-8383
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
708546
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00241054
RAILROAD MEDICARE
CO
Enumeration date
12/21/2005
Last updated
11/23/2015
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