=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972310456
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JANE S. HOPKINS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/17/2024
-----------------------------------------------------
Last Update Date | 12/26/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5757 S 34TH ST STE 300
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68516-6661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-405-4942
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 21763
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68542-1763
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-405-4942
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KELI KOLEGRAFF
-----------------------------------------------------
Credential | MD, PHD
-----------------------------------------------------
Telephone | 402-405-4942
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------