MEDICARE: DR. JARROD ALLEN NELSON O.D.

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
1	152W00000X	Optometrist	2410	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	159371	OTHER	MN	EYEMED
2	22-02649	OTHER	MN	MEDICA
3	817S9NE	OTHER	MN	BLUE CROSS BLUE SHIELD
4	HP28522	OTHER	MN	HEALTH PARTNERS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	916771028513	OTHER	MN	PREFERRED ONE

General Provider Information

NPI Number	:	1487785499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARROD ALLEN NELSON O.D.

Provider Business Mailing Address
First Line	:	1479 485TH ST W
Second Line	:
City	:	STANCHFIELD
State	:	MN
Zip	:	55080-4216
Country	:	US
Telephone Number	:	763-691-8252
Fax Number	:

Provider Business Practice Location Address
First Line	:	5366 386TH ST NE
Second Line	:
City	:	NORTH BRANCH
State	:	MN
Zip	:	55056-5833
Country	:	US
Telephone Number	:	651-674-6844
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	01/05/2024

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