Healthcare Provider Details

I. General information

NPI: 1215948591
Provider Name (Legal Business Name): JACQUELINE B ESCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACQUELINE B BENDER MD

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2915 GRANT STREET
OMAHA NE
68111
US

IV. Provider business mailing address

102 WOODMONT BLVD STE 600
NASHVILLE TN
37205-5250
US

V. Phone/Fax

Practice location:
  • Phone: 402-457-1200
  • Fax: 402-453-1970
Mailing address:
  • Phone: 615-315-5257
  • Fax: 615-692-0547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22604
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number22604
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: