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Individual

JACKIE E ERB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
910 20TH ST, GOTHENBURG, NE 69138-1237
(308) 537-3661
Mailing address
1020 21ST ST, GOTHENBURG, NE 69138-2501
(402) 318-1735

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
69233
NE
367500000X
Certified Registered Nurse Anesthetist
Primary
101285
NE
390200000X
Student in an Organized Health Care Education/Training Program
201242161RN
OR

Other

Enumeration date
09/28/2012
Last updated
01/29/2015
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