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General NPI Number Information
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NPI Number | 1538179205
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Entity Type | Individual
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Provider Name | JEANNE P. NELSON CRNP, PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 3007 MEMORIAL PKWY SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5393
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Country | US
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Telephone | 256-882-2003
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Fax | 256-705-4630
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Provider Business Mailing Address
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Address Line | PO BOX 18084
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City | HUNTSVILLE
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State | AL
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Zip | 35804-8084
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Country | US
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Telephone | 256-882-2003
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Fax | 256-705-4630
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 770
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1-099348
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License Number State | AL
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