Individual
JASON R HENNESSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1600 S 48TH ST, SUITE 600, LINCOLN, NE 68506-1275
(402) 483-3333
(402) 483-3395
Mailing address
1600 S 48TH ST, SUITE 600, LINCOLN, NE 68506-1275
(402) 483-3333
(402) 483-3395
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
989
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1052768
NCCPA
NE
01
—
37394
BCBSNE
NE
01
—
989
PA LICENSE
NE
Enumeration date
08/28/2006
Last updated
03/07/2023
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