| NPI | 1831502244 |
|---|---|
| Former Name | JENNA KAY NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MN 3385) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ND 741) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2019-09-16 |