Healthcare Provider Details

I. General information

NPI: 1861638504
Provider Name (Legal Business Name): JENNIFER CHIPPS AUSTIN ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER L CHIPPS ANP

II. Dates (important events)

Enumeration Date: 12/31/2008
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 PIONEER WOODS DR
LINCOLN NE
68506-7548
US

IV. Provider business mailing address

4004 PIONEER WOODS DR
LINCOLN NE
68506-7548
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-4900
  • Fax: 402-484-6456
Mailing address:
  • Phone: 402-484-4900
  • Fax: 402-484-6456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN187723
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number111962
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: