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NPI Code Detail

MEDICARE: JESSICA MAXTON RN

MEDICARE: JESSICA MAXTON RN
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
1163WS0200XSchool Registered Nurse93051NE

General Provider Information

NPI Number : 1336816891
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MAXTON RN
Provider Business Mailing Address
First Line : 1345 B ST APT 1
Second Line :
City : LINCOLN
State : NE
Zip : 68502-1396
Country : US
Telephone Number : 260-239-1078
Fax Number :
Provider Business Practice Location Address
First Line : 5530 N 66TH ST
Second Line :
City : OMAHA
State : NE
Zip : 68104-1550
Country : US
Telephone Number : 531-299-1564
Fax Number : 531-299-1559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2021
Last Update Date : 08/24/2021

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