Provider Demographics
NPI:1225397862
Name:GENUA-MCDANIEL, JENNIFER A (BA (HONS), FCHCEM)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:A
Last Name:GENUA-MCDANIEL
Suffix:
Gender:F
Credentials:BA (HONS), FCHCEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3929 S 147TH ST
Mailing Address - Street 2:ALTECH PLAZA, SUITE 100A
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5527
Mailing Address - Country:US
Mailing Address - Phone:402-504-4415
Mailing Address - Fax:
Practice Address - Street 1:3929 S 147TH ST
Practice Address - Street 2:ALTECH PLAZA, SUITE 100A
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5527
Practice Address - Country:US
Practice Address - Phone:402-504-4415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2013-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator