Healthcare Provider Details

I. General information

NPI: 1720900798
Provider Name (Legal Business Name): JESSY LOPES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 E 13TH ST # C
CRETE NE
68333-2200
US

IV. Provider business mailing address

1922 EASTGATE DR
CRETE NE
68333-3509
US

V. Phone/Fax

Practice location:
  • Phone: 402-418-2472
  • Fax:
Mailing address:
  • Phone: 402-418-2472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: