Individual
TRACI L JURRENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1120 N 103RD PLZ, SUITE 100, OMAHA, NE 68114-1114
(402) 391-5055
(402) 384-4202
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
22554
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100264481-00
—
NE
05
—
1588641385
—
IA
Enumeration date
12/22/2005
Last updated
06/12/2015
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