Jenna S Beideck, APRN

Individual provider Active NPI Nurse Practitioner · Lincoln, NE

NPI 1366899684 · NPPES record last updated Dec 31, 2018

Key facts

NPI
1366899684
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
112687 (NE)
Practice address
1600 S 48TH St
Ste 600
Lincoln, NE 68506-1299
Phone
(402) 483-3333
NPI assigned
May 17, 2016
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)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN.0992527COMDNurse Practitioner
RN.1620370COMDNurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN.1620370 CO
Nurse Practitioner 363L00000X APN.0992527 CO
Nurse Practitioner 363L00000X 112687 NE Yes

Addresses

Primary practice location

1600 S 48TH St
Ste 600
Lincoln, NE 68506-1299

Mailing address

PO Box 6607
Lincoln, NE 68506-0607
Phone (402) 483-3333

Other providers in Lincoln, NE

All providers in Lincoln, NE · Nurse Practitioner in Nebraska

Sources for this page

Verify at the official NPI Registry.