Individual
MRS. PENNI F JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
6940 VAN DORN ST STE 201, LINCOLN, NE 68506-2858
(402) 413-6363
(402) 512-9133
Mailing address
4445 S 86TH ST # 100, LINCOLN, NE 68526-9225
(402) 414-4200
(402) 414-4202
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1137
NE
Other
Enumeration date
10/04/2006
Last updated
04/07/2025
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