Provider Demographics
NPI:1043547169
Name:NELAN, JODI PALMER (MSW)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:PALMER
Last Name:NELAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5139 N MILLER RD
Mailing Address - Street 2:
Mailing Address - City:BRADY
Mailing Address - State:NE
Mailing Address - Zip Code:69123-2981
Mailing Address - Country:US
Mailing Address - Phone:404-259-5202
Mailing Address - Fax:
Practice Address - Street 1:5139 N MILLER RD
Practice Address - Street 2:
Practice Address - City:BRADY
Practice Address - State:NE
Practice Address - Zip Code:69123-2981
Practice Address - Country:US
Practice Address - Phone:404-259-5202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CO20551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical