| Jennifer Daggett Inc | |
|
11840 Nicholas St Omaha NE 68154-4475 | |
| (402) 289-8990 | |
| (402) 234-8750 |
| Full Name | Jennifer Daggett Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11840 Nicholas St, Omaha, Nebraska |
| Authorized Official Name and Position | Jennifer Daggett (OWNER & PROVIDER) |
| Authorized Official Contact | 4022898990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Daggett Inc 11840 Nicholas St Omaha NE 68154-4475 Ph: (402) 289-8990 | Jennifer Daggett Inc 11840 Nicholas St Omaha NE 68154-4475 Ph: (402) 289-8990 |
| NPI Number | 1417504549 |
|---|---|
| Provider Enumeration Date | 08/22/2019 |
| Last Update Date | 11/01/2019 |
| Medicare PECOS PAC ID | 7416289723 |
|---|---|
| Medicare Enrollment ID | O20191105002236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417504549 | NPI | - | NPPES |
| 1699782870 | Other | NE | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jennifer J Daggett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699782870 PECOS PAC ID: 7517968209 Enrollment ID: I20120224000422 |
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