Healthcare Provider Details

I. General information

NPI: 1710115563
Provider Name (Legal Business Name): JENNIFER LEA NEILAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11844 STANDING STONE DR STE 200
GRETNA NE
68028-8111
US

IV. Provider business mailing address

11844 STANDING STONE DR STE 200
GRETNA NE
68028-8111
US

V. Phone/Fax

Practice location:
  • Phone: 402-800-8595
  • Fax: 844-858-0962
Mailing address:
  • Phone: 402-800-8595
  • Fax: 844-858-0962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number111024
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: