Provider Demographics
NPI:1003923855
Name:BRAMMEIER, JENNIFER LYNN (OD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:BRAMMEIER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:17610 JEFFERSON STREET
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135
Mailing Address - Country:US
Mailing Address - Phone:402-991-5776
Mailing Address - Fax:402-697-4834
Practice Address - Street 1:12850 L STREET
Practice Address - Street 2:WALMART VISION CENTER
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137
Practice Address - Country:US
Practice Address - Phone:402-697-1852
Practice Address - Fax:402-697-4834
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI4721Medicare ID - Type Unspecified
U71413Medicare UPIN