Healthcare Provider Details

I. General information

NPI: 1194651323
Provider Name (Legal Business Name): ANTHONY FRANKLIN JETER PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3614 TWIN CREEK DR
BELLEVUE NE
68123-4065
US

IV. Provider business mailing address

810 CALAIS ST
BELLEVUE NE
68123-3635
US

V. Phone/Fax

Practice location:
  • Phone: 402-292-3580
  • Fax:
Mailing address:
  • Phone: 402-669-9907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18033
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: