Individual
JACOB L. RUNYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
305 N 37TH ST, NORFOLK, NE 68701-3275
(402) 370-4100
(402) 370-4101
Mailing address
PO BOX 70, STUART, NE 68780-0070
(402) 924-3777
(402) 924-3776
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1775
NE
363A00000X
Physician Assistant
Primary
1775
NE
Other
Enumeration date
10/28/2013
Last updated
08/30/2023
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