Individual
JAYCOB DANIEL EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2211 S 38TH ST, LINCOLN, NE 68506-6024
(402) 326-3554
Mailing address
2211 S 38TH ST, LINCOLN, NE 68506-6024
(402) 326-3554
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2264
NE
Other
Enumeration date
08/10/2018
Last updated
04/15/2022
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