MEDICARE: MRS. JANELLE ROXANNE REMINGTON PH.D.

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
1	103G00000X	Clinical Neuropsychologist	918	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	84619	OTHER	NE	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1720139058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANELLE ROXANNE REMINGTON PH.D.

Provider Business Mailing Address
First Line	:	5020 ELK RIDGE RD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68516-3370
Country	:	US
Telephone Number	:	402-440-8025
Fax Number	:	402-328-2425

Provider Business Practice Location Address
First Line	:	5020 ELK RIDGE RD
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68516-3370
Country	:	US
Telephone Number	:	402-440-8025
Fax Number	:	402-328-2425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	05/26/2026

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