Individual
JOSE BAJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 N ALPHA ST, GRAND ISLAND, NE 68803-4320
(308) 382-2010
Mailing address
1623 BOYCE ST, HASTINGS, NE 68901-4348
(305) 903-4145
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
000-00-00
NE
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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