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General NPI Number Information
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NPI Number | 1235808445
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Entity Type | Individual
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Provider Name | JAZMIN YACAMAN STRUBLE PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/10/2021
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 8207 NORTHWOODS DR STE 100
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City | LINCOLN
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State | NE
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Zip | 68505-2093
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Country | US
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Telephone | 402-484-3440
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Fax |
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Provider Business Mailing Address
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Address Line | 2107 N CLARKSON ST
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City | FREMONT
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State | NE
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Zip | 68025-2625
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Country | US
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Telephone | 402-317-8659
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2571
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License Number State | NE
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