Healthcare Provider Details

I. General information

NPI: 1235061763
Provider Name (Legal Business Name): JENNIFER THORNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18711 SCHOFIELD DR
OMAHA NE
68136-6453
US

IV. Provider business mailing address

18718 SCHOFIELD DR
OMAHA NE
68136-6453
US

V. Phone/Fax

Practice location:
  • Phone: 402-312-9784
  • Fax:
Mailing address:
  • Phone: 402-312-9784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: