Individual
MS. JENNIFER CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
515 N 162ND AVE STE 300, OMAHA, NE 68118-2540
(402) 354-1200
(402) 354-1205
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1136
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37833
BCBS
NE
05
—
47073679913
—
NE
05
—
47081304012
—
NE
01
—
68154A016
TRICARE
NE
01
—
P00153597
RAILROAD MEDICARE
NE
Enumeration date
05/31/2005
Last updated
04/21/2025
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