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General NPI Number Information
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NPI Number | 1063494524
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Entity Type | Individual
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Provider Name | JEREMIAH NELSON MD
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Gender | Male
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 2880 N TENAYA WAY STE 320
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City | LAS VEGAS
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State | NV
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Zip | 89128-0642
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Country | US
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Telephone | 702-862-8226
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Fax | 702-862-8227
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Provider Business Mailing Address
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Address Line | 6355 S BUFFALO DR FL 3
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City | LAS VEGAS
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State | NV
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Zip | 89113-2133
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Country | US
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Telephone | 702-216-3346
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME 92825
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD-45607
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35099088
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | ME0092825
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 35099088
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 23921
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License Number State | NV
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