Individual
JENNIFER JEWELL BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 SHELTON ST, CHADRON, NE 69337-2312
(308) 432-2747
(308) 432-5092
Mailing address
300 SHELTON ST, CHADRON, NE 69337-2312
(308) 432-2747
(308) 432-5092
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-048223426
—
NE
Enumeration date
08/07/2014
Last updated
08/07/2014
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