Provider Demographics
NPI:1093761132
Name:STEMPER, JESSICA D (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:D
Last Name:STEMPER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:NE
Mailing Address - Zip Code:68920-0665
Mailing Address - Country:US
Mailing Address - Phone:308-928-2103
Mailing Address - Fax:308-928-2560
Practice Address - Street 1:715 BROWN ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:NE
Practice Address - Zip Code:68920-2132
Practice Address - Country:US
Practice Address - Phone:308-928-2103
Practice Address - Fax:308-928-2560
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1039363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025411700Medicaid
NE10025988200Medicaid
NE10025988300Medicaid
KS200421770BMedicaid
KS200421770CMedicaid
NE10025412200Medicaid
NEP00340971OtherRAILROAD MEDICARE
KS200421770AMedicaid
NE10025988300Medicaid
NE5898590001Medicare NSC
NEP00340971OtherRAILROAD MEDICARE
NEP67055Medicare UPIN