Healthcare Provider Details

I. General information

NPI: 1871992438
Provider Name (Legal Business Name): JESSICA CHELEWSKI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 S LOCUST ST STE F
GRAND ISLAND NE
68801-8200
US

IV. Provider business mailing address

1300 S LOCUST ST STE F
GRAND ISLAND NE
68801-8200
US

V. Phone/Fax

Practice location:
  • Phone: 308-398-0350
  • Fax: 308-398-0351
Mailing address:
  • Phone: 308-398-0350
  • Fax: 308-398-0351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSICA ANN CHELEWSKI
Title or Position: APRN, FNP-C
Credential: APRN, FNP-C
Phone: 308-398-0350