MEDICARE: JESSIE M. KERCHAL M.S. CCC-SLP

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	235Z00000X	Speech-Language Pathologist	1590	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912333246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSIE M. KERCHAL M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	74322 AVENUE 350
Second Line	:
City	:	WAUNETA
State	:	NE
Zip	:	69045-7116
Country	:	US
Telephone Number	:	308-350-0705
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 N TECUMSEH
Second Line	:
City	:	WAUNETA
State	:	NE
Zip	:	69045-9726
Country	:	US
Telephone Number	:	308-394-5333
Fax Number	:	308-365-1927

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

Provider Enumeration Date	:	09/18/2013
Last Update Date	:	02/04/2022

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Directions to “ JESSIE M. KERCHAL M.S. CCC-SLP” Practice Location

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