Provider Demographics
NPI:1174022586
Name:NELSON, JENNIFER CATHERINE MARIE (FNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CATHERINE MARIE
Last Name:NELSON
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:151 SW SHEVLIN HIXON DR STE 201
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3233
Mailing Address - Country:US
Mailing Address - Phone:541-213-2265
Mailing Address - Fax:541-508-5461
Practice Address - Street 1:151 SW SHEVLIN HIXON DR STE 201
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3233
Practice Address - Country:US
Practice Address - Phone:541-213-2265
Practice Address - Fax:541-508-5461
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR201801111NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily