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NPI Code Detail

MEDICARE: JENNA MARIE ELWOOD

MEDICARE: JENNA MARIE ELWOOD
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
1225200000XPhysical Therapy Assistant1993NE

General Provider Information

NPI Number : 1902741622
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA MARIE ELWOOD
Provider Business Mailing Address
First Line : 14042 ORCHARD AVE
Second Line :
City : OMAHA
State : NE
Zip : 68137-1562
Country : US
Telephone Number : 402-216-9776
Fax Number :
Provider Business Practice Location Address
First Line : 20800 W MAPLE RD
Second Line :
City : ELKHORN
State : NE
Zip : 68022-5108
Country : US
Telephone Number : 402-216-9776
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2026
Last Update Date : 04/20/2026

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Directions to “ JENNA MARIE ELWOOD ” Practice Location

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