Provider Demographics
NPI:1922690551
Name:NELSON-HAWKS, JENNIFER (NATUROPATHIC DOCTOR)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:NELSON-HAWKS
Suffix:
Gender:F
Credentials:NATUROPATHIC DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11005
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83002-1005
Mailing Address - Country:US
Mailing Address - Phone:307-699-1740
Mailing Address - Fax:
Practice Address - Street 1:1325 S HWY 89 APT 113
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001-8293
Practice Address - Country:US
Practice Address - Phone:307-732-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath