Healthcare Provider Details

I. General information

NPI: 1275777468
Provider Name (Legal Business Name): JENNIFER B ROCHA APRN-DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER B SMITH FRIEND, DNP, APRN

II. Dates (important events)

Enumeration Date: 05/01/2009
Last Update Date: 06/17/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

7500 MERCY RD
OMAHA NE
68124-2319
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-8065
  • Fax: 402-955-3393
Mailing address:
  • Phone: 402-398-6017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number110972
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: