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NPI Code Detail

MEDICARE: JESSICA ANNE VIRGIL MOT, OTR/L, CBIS

MEDICARE: JESSICA ANNE VIRGIL MOT, OTR/L, CBIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist1459NE

General Provider Information

NPI Number : 1043150782
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ANNE VIRGIL MOT, OTR/L, CBIS
Provider Business Mailing Address
First Line : 5401 SOUTH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2150
Country : US
Telephone Number : 402-413-3665
Fax Number :
Provider Business Practice Location Address
First Line : 5401 SOUTH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2150
Country : US
Telephone Number : 402-413-3665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2026
Last Update Date : 03/31/2026

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