Healthcare Provider Details

I. General information

NPI: 1063328557
Provider Name (Legal Business Name): JENA ROEBER OTR/L, PHS, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11015 S 218TH ST
GRETNA NE
68028-5121
US

IV. Provider business mailing address

11015 S 218TH ST
GRETNA NE
68028-5121
US

V. Phone/Fax

Practice location:
  • Phone: 402-440-0613
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2203
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: