Individual
JENNY S BELITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
350 W 23RD ST, STE A, FREMONT, NE 68025-2592
(402) 721-7077
(402) 753-6056
Mailing address
PO BOX 11724, BELFAST, ME 04915-4008
(402) 721-7077
(402) 753-6056
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
384
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025238700
—
NE
01
—
37825
BCBS
NE
01
—
P00243532
RR MEDICARE
—
Enumeration date
07/27/2006
Last updated
07/17/2013
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