Healthcare Provider Details

I. General information

NPI: 1235847906
Provider Name (Legal Business Name): JESSICA P HUTCHISON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA P SCHENCK PA-C

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6829 N 72ND ST STE 7500
OMAHA NE
68122-1733
US

IV. Provider business mailing address

6829 N 72ND ST STE 7500
OMAHA NE
68122-1733
US

V. Phone/Fax

Practice location:
  • Phone: 402-717-6870
  • Fax: 402-717-6874
Mailing address:
  • Phone: 402-717-6870
  • Fax: 402-717-6874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number116900
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2838
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: