Individual
JEREMY R JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
7500 MERCY RD STE 1355, OMAHA, NE 68124-2319
(402) 717-4866
(402) 717-6068
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
115221
IA
367500000X
Certified Registered Nurse Anesthetist
Primary
101474
NE
367500000X
Certified Registered Nurse Anesthetist
D115221
IA
Other
Enumeration date
01/10/2018
Last updated
08/19/2020
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