Individual
JENNA LEE DESOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
17607 GOLD PLZ, OMAHA, NE 68130-5606
(402) 991-8468
Mailing address
17607 GOLD PLZ, OMAHA, NE 68130-5606
(402) 991-8468
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
76102
NE
363LF0000X
Family Nurse Practitioner
Primary
112417
NE
Other
Enumeration date
01/30/2018
Last updated
08/04/2020
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