Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 15738 | OK |
NPI | 1013939479 |
---|---|
Provider Name | Dr. Jennifer K. Nelson |
First Address | Oklahoma City, OK 73120-5045 |
Second Address | Oklahoma City, OK 73120-5045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 28/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100137390B | (05) | OK |
160015242 | (02) | OK |