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NPI Code Detail

MEDICARE: MISS JENNIFER LEA FLANAGAN M.A. CCC-SLP

MEDICARE: MISS JENNIFER LEA FLANAGAN M.A. CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist656NE

General Provider Information

NPI Number : 1083748446
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNIFER LEA FLANAGAN M.A. CCC-SLP
Provider Business Mailing Address
First Line : 17616 MARCY ST
Second Line :
City : OMAHA
State : NE
Zip : 68118-3545
Country : US
Telephone Number : 402-333-6256
Fax Number :
Provider Business Practice Location Address
First Line : 323 S 132ND ST
Second Line :
City : OMAHA
State : NE
Zip : 68154-2106
Country : US
Telephone Number : 402-330-4272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 07/08/2007

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Directions to “ MISS JENNIFER LEA FLANAGAN M.A. CCC-SLP” Practice Location

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