Individual
JENNIFER NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
106 WADSWORTH ST, RADFORD, VA 24141-1439
(540) 639-9023
Mailing address
830 DAVIS ST, SUITE 1, BLACKSBURG, VA 24060-7010
(540) 443-7400
(540) 552-2720
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101256585
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366486664
—
VA
Enumeration date
07/10/2009
Last updated
01/04/2022
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