Individual
JESSICA NIEDFELT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1620 W JOHN ST, GRAND ISLAND, NE 68801-6323
(308) 391-0023
Mailing address
1620 W JOHN ST, GRAND ISLAND, NE 68801-6323
(308) 391-0023
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
NE
Other
Enumeration date
02/07/2025
Last updated
02/07/2025
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