Jerald Jerome Nelson in Lake Park - Clinical
Jerald Jerome Nelson - NPI 1629293758
Jerald Jerome Nelson is a Clinical in Lake Park, Minnesota. Jerald Jerome Nelson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jerald Jerome Nelson is 1629293758. The last update date is 2007-07-08.
Jerald Jerome Nelson's current location address is 13299 Wildflower Ln, Lake Park, Minnesota. You can contact this provider via phone number 7013184292. The mailing address for Jerald Jerome Nelson is 13299 Wildflower Ln, Lake Park, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerald Jerome Nelson |
|---|---|
| Address | 13299 Wildflower Ln, Lake Park, Minnesota |
| Phone Number | 7013184292 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | LICSW |
NPI Number Detail
| NPI Number | 1629293758 |
|---|---|
| Provider Enumeration Date | 2007-04-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 13299 Wildflower Ln |
|---|---|
| City | Lake Park |
| State | Minnesota (MN) |
| Post Code | 565549132 |
| Phone Number | 7013184292 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 7373 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the Jerald Jerome Nelson's unique identification number?
The Jerald Jerome Nelson has been assigned the NPI (National Provider Identifier) Number 1629293758 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical address where Jerald Jerome Nelson is geographically located?
The Jerald Jerome Nelson is physically situated at the following location: 13299 Wildflower Ln, Lake Park, MN, 565549132.
What is Jerald Jerome Nelson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Jerald Jerome Nelson's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 1041C0700X.
On what date did the Jerald Jerome Nelson receive its 1629293758 assignment from the Centers for Medicare & Medicaid Services?
The Jerald Jerome Nelson was assigned its 1629293758 by the Centers for Medicare & Medicaid Services on 2007-04-16.
When was the information regarding Jerald Jerome Nelson most recently updated?
The details pertaining to the Jerald Jerome Nelson, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
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