Individual
JENNIFER LYNNE BUSSKOHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 346-8800
Mailing address
2813 LEIGH LN, PAPILLION, NE 68133-3377
(402) 301-7758
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
660
NE
Other
Enumeration date
07/03/2006
Last updated
07/08/2007
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