Individual
JODI LYNN CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
EMILE 42ND ST, OMAHA, NE 68198-0001
(402) 559-4015
(402) 559-8715
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
(402) 559-6195
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6772
NE
208000000X
Pediatrics Physician
6772
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6772
TEMPORARY EDUCATION PERMIT
NE
Enumeration date
06/19/2012
Last updated
05/13/2016
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