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Individual

JOEL D JASA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.-C.

Contact information

Practice address
620 N DIERS AVE, STE. 200, GRAND ISLAND, NE 68803-4984
(308) 384-5400
(308) 384-5201
Mailing address
620 N DIERS AVE, STE. 200, GRAND ISLAND, NE 68803-4984
(308) 384-5400
(308) 384-5201

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1856
NE
363A00000X
Physician Assistant
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47054564512
NE
Enumeration date
05/18/2010
Last updated
10/23/2014
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