Healthcare Provider Details

I. General information

NPI: 1487015913
Provider Name (Legal Business Name): MISS MEGAN JANSSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 S 70TH ST STE 305
LINCOLN NE
68510-2471
US

IV. Provider business mailing address

7200 S 88TH ST APT 725
LINCOLN NE
68526-6113
US

V. Phone/Fax

Practice location:
  • Phone: 402-434-5600
  • Fax: 402-434-5601
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number6843
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number101339
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: