| Michael Jan Nelson Phd | |
|
420 1st Ave S Wisconsin Rapids WI 54495 | |
| (715) 424-3400 | |
| (715) 424-3441 |
| Full Name | Michael Jan Nelson Phd |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 420 1st Ave S, Wisconsin Rapids, Wisconsin |
| Authorized Official Name and Position | Julie A Sigler Edmundson (ADMINISTRATOR) |
| Authorized Official Contact | 7157121370 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Jan Nelson Phd Po Box 1535 Wisconsin Rapids WI 54495-1535 Ph: (715) 424-3400 | Michael Jan Nelson Phd 420 1st Ave S Wisconsin Rapids WI 54495 Ph: (715) 424-3400 |
| NPI Number | 1205097870 |
|---|---|
| Provider Enumeration Date | 06/17/2008 |
| Last Update Date | 08/29/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205097870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | 1298 (Wisconsin) | Primary |
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