Healthcare Provider Details

I. General information

NPI: 1750211637
Provider Name (Legal Business Name): JO LYNN MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E 12TH ST
NORTH PLATTE NE
69101-2365
US

IV. Provider business mailing address

7929 W CENTER RD
OMAHA NE
68124-3104
US

V. Phone/Fax

Practice location:
  • Phone: 402-441-7940
  • Fax: 402-441-8491
Mailing address:
  • Phone: 402-709-3667
  • Fax: 402-441-8491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14933
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: