Provider Demographics
NPI:1841517463
Name:NELSON, JENNIFER TOWLES MCCLELLAN (MD, MPH)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:TOWLES MCCLELLAN
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:TOWLES
Other - Last Name:MCCLELLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH
Mailing Address - Street 1:49 JESSE HILL JR DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:49 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3049
Practice Address - Country:US
Practice Address - Phone:404-778-1440
Practice Address - Fax:404-778-1401
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA69818208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics