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NPI Code Detail

MEDICARE: JESSICA NELSON RN

MEDICARE: JESSICA NELSON RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WS0200XSchool Registered Nurse222727-30WI

General Provider Information

NPI Number : 1891627980
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA NELSON RN
Provider Business Mailing Address
First Line : N88W18561 DUKE ST
Second Line :
City : MENOMONEE FALLS
State : WI
Zip : 53051-1905
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 458 LAKE ST
Second Line :
City : PEWAUKEE
State : WI
Zip : 53072-3630
Country : US
Telephone Number : 262-701-5532
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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