Healthcare Provider Details

I. General information

NPI: 1336050111
Provider Name (Legal Business Name): JENNIFER WETZEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S 44TH ST
LINCOLN NE
68506-1120
US

IV. Provider business mailing address

1210 S 44TH ST
LINCOLN NE
68510-4709
US

V. Phone/Fax

Practice location:
  • Phone: 402-481-3147
  • Fax:
Mailing address:
  • Phone: 308-850-5357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17690
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: