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General NPI Number Information
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NPI Number | 1043132319
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Entity Type | Individual
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Provider Name | JENNIFER KMITTA STFA
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Gender | Female
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 2255 S 132ND ST
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City | OMAHA
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State | NE
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Zip | 68144-2573
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Country | US
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Telephone | 531-867-4466
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Fax | 531-272-5099
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Provider Business Mailing Address
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Address Line | 11254 W LAKESHORE DR
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City | BLAIR
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State | NE
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Zip | 68008-6232
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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