Jan Alvin Nelson, RPH

Key facts

NPI

1124233267

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

113081 (MN)

Practice address

115 West Jessie Street
Rushford, MN 55971

Phone

(507) 864-2153

Fax

(507) 864-2143

NPI assigned

May 11, 2007

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Pharmacist

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124233267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 OLMSTEAD ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559872932",
            "telephone_number": "507-454-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WEST JESSIE STREET",
            "city": "RUSHFORD",
            "state": "MN",
            "postal_code": "55971",
            "telephone_number": "507-864-2153",
            "fax_number": "507-864-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JAN",
        "middle_name": "ALVIN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "113081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rushford, MN

• Good Shepherd Lutheran Home
• Katie Marie Halder, RN, CNP
• David Gerhard Hinz, D.C.
• Gary Marcoux, D.D.S.
• Diane Beth Montgomery, PT
• Nurse Practitioner Associates, LTD.
• Paramed Services, Inc.
• Sherwood E Peterson Jr., R.PH.
• Kristine Michele Raadt, DPT
• Stephanie Jane Rae, DPT

All providers in Rushford, MN · Pharmacist in Minnesota