Healthcare Provider Details

I. General information

NPI: 1578486742
Provider Name (Legal Business Name): JENNIFER BORER APRN-PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 N 91ST ST
OMAHA NE
68134-4031
US

IV. Provider business mailing address

7101 NEWPORT AVE
OMAHA NE
68152-2164
US

V. Phone/Fax

Practice location:
  • Phone: 402-215-5623
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number117390
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number80054
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: