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General NPI Number Information
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NPI Number | 1831512862
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Entity Type | Individual
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Provider Name | JED CHRISTIAN SANDERS APRN
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Gender | Male
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 989550 NEBRASKA MEDICAL CTR
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City | OMAHA
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State | NE
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Zip | 68198-7545
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Country | US
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Telephone | 402-559-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 4214 BURT ST
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City | OMAHA
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State | NE
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Zip | 68131-1734
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Country | US
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Telephone | 402-679-1416
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 111621
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License Number State | NE
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