Healthcare Provider Details

I. General information

NPI: 1285015230
Provider Name (Legal Business Name): JENNA ALLISON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N 84TH ST
OMAHA NE
68114-4101
US

IV. Provider business mailing address

21804 G ST
ELKHORN NE
68022-3313
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-3950
  • Fax:
Mailing address:
  • Phone: 402-362-9132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number31138
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7437
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: