1609966043 NPI number — MS. JANET R. JURGENSEN DUBA NP A.P.R.N. N.P.

Table of content: MS. JANET R. JURGENSEN DUBA NP A.P.R.N. N.P. (NPI 1609966043)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609966043 NPI number — MS. JANET R. JURGENSEN DUBA NP A.P.R.N. N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JURGENSEN DUBA NP
Provider First Name:
JANET
Provider Middle Name:
R.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
A.P.R.N. N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUBA
Provider Other First Name:
JANET
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
A.P.R.N. N.P.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1609966043
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
908 N HOWARD AVE
Provider Second Line Business Mailing Address:
STE 102
Provider Business Mailing Address City Name:
GRAND ISLAND
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68803-3529
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
308-675-1931
Provider Business Mailing Address Fax Number:
308-675-1934

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
908 N HOWARD AVE
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
GRAND ISLAND
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68803-3529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-675-1931
Provider Business Practice Location Address Fax Number:
308-675-1934
Provider Enumeration Date:
10/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  110175 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10026009700 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com