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NPI Code Detail

MEDICARE: JAIME LENZ BSN

MEDICARE: JAIME LENZ BSN
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
1163WS0200XSchool Registered NurseR39564SD

General Provider Information

NPI Number : 1699384453
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAIME LENZ BSN
Provider Business Mailing Address
First Line : 3625 G ST
Second Line :
City : SOUTH SIOUX CITY
State : NE
Zip : 68776-3466
Country : US
Telephone Number : 402-494-3061
Fax Number :
Provider Business Practice Location Address
First Line : 3625 G ST
Second Line :
City : SOUTH SIOUX CITY
State : NE
Zip : 68776-3466
Country : US
Telephone Number : 402-494-3061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2020
Last Update Date : 07/28/2020

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Directions to “ JAIME LENZ BSN” Practice Location

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