Healthcare Provider Details

I. General information

NPI: 1336417070
Provider Name (Legal Business Name): JESSICA LYNN BISSEN BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LYNN LYTLE BSN, RN

II. Dates (important events)

Enumeration Date: 12/08/2011
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 S 84TH ST
OMAHA NE
68124-3215
US

IV. Provider business mailing address

8200 DODGE ST CHILDREN'S HOSPITAL & MEDICAL CENTER
OMAHA NE
68114-4113
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-7777
  • Fax:
Mailing address:
  • Phone: 402-955-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number123409
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: