Nelson, Jerry Alan

Nelson, Jerry Alan is an individual health care provider with primary practice located at 905 Franklin St , Waterloo IA 50703-4407. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Nelson, Jerry Alan can be contacted via phone (319) 272-4300.

Contact Information

Primary practice address
905 Franklin St Waterloo IA 50703-4407
Phone: (319) 272-4300
Fax: (319) 272-4411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36749 Iowa

Profile Details

NPI number 1831197607
LBN Legal business name Nelson, Jerry Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Jul 22nd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831197607 NPPES
Iowa MEDICAID 0076372
Iowa Other 21827
Iowa Other 21828
Iowa MEDICAID 0731935
Iowa MEDICAID 1731935

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