MEDICARE: JENNIFER J ANDRADE

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
1	372500000X	Chore Provider	36371264	NE

General Provider Information

NPI Number	:	1912708728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER J ANDRADE

Provider Business Mailing Address
First Line	:	2003 MORRIE DR
Second Line	:
City	:	BELLEVUE
State	:	NE
Zip	:	68123-4027
Country	:	US
Telephone Number	:	402-301-7758
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 SAC BLVD STE 2A7
Second Line	:
City	:	OFFUTT AFB
State	:	NE
Zip	:	68113-5213
Country	:	US
Telephone Number	:	402-912-8569
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	03/19/2025

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Directions to “ JENNIFER J ANDRADE ” Practice Location

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