Healthcare Provider Details

I. General information

NPI: 1013870104
Provider Name (Legal Business Name): JESSICA SPIEGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 W 21ST ST
KEARNEY NE
68845-5160
US

IV. Provider business mailing address

PO BOX 939
BELLEVUE NE
68005-0939
US

V. Phone/Fax

Practice location:
  • Phone: 308-750-4776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: