Healthcare Provider Details

I. General information

NPI: 1982184396
Provider Name (Legal Business Name): JAMIE CRAFT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2018
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 PINE LAKE RD STE 210
LINCOLN NE
68516-5497
US

IV. Provider business mailing address

3901 PINE LAKE RD STE 210
LINCOLN NE
68516-5497
US

V. Phone/Fax

Practice location:
  • Phone: 402-488-7337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number114861
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number77425
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: