Healthcare Provider Details

I. General information

NPI: 1144104852
Provider Name (Legal Business Name): JENNA LYNN FALCON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 WOOLWORTH AVE
OMAHA NE
68105-1850
US

IV. Provider business mailing address

15302 REDWOOD ST
OMAHA NE
68138-6494
US

V. Phone/Fax

Practice location:
  • Phone: 402-995-4104
  • Fax:
Mailing address:
  • Phone: 402-699-9257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number80606
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number80606
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: