Healthcare Provider Details

I. General information

NPI: 1982683918
Provider Name (Legal Business Name): JENNA ELIZABETH FIALA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 11/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 A ST SUITE 200
LINCOLN NE
68510-4299
US

IV. Provider business mailing address

7001 A ST SUITE 200
LINCOLN NE
68510-4299
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-3199
  • Fax: 402-484-3196
Mailing address:
  • Phone: 402-484-3199
  • Fax: 402-484-3196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number43337
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25147
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: