Healthcare Provider Details

I. General information

NPI: 1386557411
Provider Name (Legal Business Name): JACOB BRAND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 340
HOMER NE
68030-0340
US

IV. Provider business mailing address

PO BOX 340
HOMER NE
68030-0340
US

V. Phone/Fax

Practice location:
  • Phone: 402-698-2377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number20250007781
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: