Jenna Allen, MSCCCSLP – Speech-Language Pathologist

Key facts

NPI: 1033489208
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: 1428 (NE)
Practice address: 1400 Mark Dr
Wahoo, NE 68066-4023
Phone: (402) 443-5017
NPI assigned: Jan 5, 2012
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
1428	NE	MD	Physician Assistant

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	1428	NE	Yes

Addresses

Primary practice location

1400 Mark Dr
Wahoo, NE 68066-4023

Mailing address

4507 N 208TH St
Elkhorn, NE 68022-6998
Phone (402) 490-9202

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 27, 2019.

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1033489208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4507 N 208TH ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680226998",
            "telephone_number": "402-490-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MARK DR",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680664023",
            "telephone_number": "402-443-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JENNA",
        "credential": "MSCCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "1428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahoo, NE

All providers in Wahoo, NE · Speech-Language Pathologist in Nebraska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.