=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376408401
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANA JENSEN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2025
-----------------------------------------------------
Last Update Date | 12/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4900 N 27TH ST
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68521-1194
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-438-3015
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13277 S 190TH ST
-----------------------------------------------------
City | BENNET
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68317-3024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-416-8677
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 11880
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------