Active NPI
Jan Alvin Nelson, RPH
- Pharmacist
- Rushford, MN
National Provider Identifier
1124233267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 113081
- Practice address
- 115 West Jessie Street
Rushford, MN 55971 - Phone
- (507) 864-2153
- Fax
- (507) 864-2143
- NPI assigned
- May 11, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 113081 | MN | Primary |
Addresses
Primary practice location
115 West Jessie Street
Rushford, MN 55971
Mailing address
526 Olmstead St
Winona, MN 55987-2932
Phone (507) 454-7168
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113081 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"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
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.