Healthcare Provider Details

I. General information

NPI: 1881589521
Provider Name (Legal Business Name): MAURIANNA R JEPSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8815 N 177TH ST
BENNINGTON NE
68007-3342
US

IV. Provider business mailing address

8815 N 177TH ST
BENNINGTON NE
68007-3342
US

V. Phone/Fax

Practice location:
  • Phone: 402-401-4074
  • Fax:
Mailing address:
  • Phone: 402-401-4074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: