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NPI Code Detail

MEDICARE: JESSICA BLACK

MEDICARE: JESSICA BLACK
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
1372600000XAdult Companion
23747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1821943747
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA BLACK
Provider Business Mailing Address
First Line : 3104 RAASCH DR
Second Line :
City : NORFOLK
State : NE
Zip : 68701-3407
Country : US
Telephone Number : 402-316-4689
Fax Number :
Provider Business Practice Location Address
First Line : 3104 RAASCH DR
Second Line :
City : NORFOLK
State : NE
Zip : 68701-3407
Country : US
Telephone Number : 402-316-4689
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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Directions to “ JESSICA BLACK ” Practice Location

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