Provider Demographics
NPI:1992703318
Name:NELSON, JAYME SUE (ARNP-C)
Entity type:Individual
Prefix:
First Name:JAYME
Middle Name:SUE
Last Name:NELSON
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-1413
Mailing Address - Country:US
Mailing Address - Phone:563-382-9765
Mailing Address - Fax:
Practice Address - Street 1:604 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-1602
Practice Address - Country:US
Practice Address - Phone:563-382-2638
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH104876363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health