Doctor Name: | DR. JERI A NELSON |
NPI Number: | 1700948502 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 21057 |
Business Practice Address: | 1300 South Dr. Winnebago, WI - 549850009 |
Business Phone Number: | 9202354910 |
Business Fax Number: | 9202362931 |
Mailing Address: | 1300 South Dr., WINNEBAGO |
State: | WI |
Postal Code: | 549850009 |
Phone Number: | 9202354910 |
Fax Number: | 9202362931 |
NPI Enumeration Date: | 12/15/2006 |
NPI Last Update Date: | 02/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2080A0000X |
License Number: | 21057 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Pediatrics |
Taxonomy Specialization: | Adolescent Medicine |
Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |