Healthcare Provider Details

I. General information

NPI: 1225946247
Provider Name (Legal Business Name): JILL EILENE NOSAL BSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S 18TH PLZ FL 2
OMAHA NE
68102-2077
US

IV. Provider business mailing address

111 S 18TH PLZ FL 2
OMAHA NE
68102-2077
US

V. Phone/Fax

Practice location:
  • Phone: 402-996-3650
  • Fax: 612-725-1307
Mailing address:
  • Phone: 402-996-3650
  • Fax: 612-725-1307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number45682
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: