Provider Demographics
NPI:1528251626
Name:NELSON, GERALD BOYD JR (OPA)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:BOYD
Last Name:NELSON
Suffix:JR
Gender:M
Credentials:OPA
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Mailing Address - Street 1:1555 NORTHWAY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4555
Mailing Address - Country:US
Mailing Address - Phone:320-257-7807
Mailing Address - Fax:320-259-8044
Practice Address - Street 1:1555 NORTHWAY DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4555
Practice Address - Country:US
Practice Address - Phone:320-257-7807
Practice Address - Fax:320-259-8044
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist