BENEDETTI, NANCY JEAN (MD)

Provider Demographics

• NPI: 1346568565
• Name: BENEDETTI, NANCY JEAN (MD)
• Entity Type: Individual
• Prefix: DR
• First Name: NANCY
• Middle Name: JEAN
• Last Name: BENEDETTI
• Gender: F
• Credentials: MD
• Mailing Address - Street 1: 988102 NEBRASKA MEDICAL CTR
• Mailing Address - City: OMAHA
• Mailing Address - State: NE
• Mailing Address - Zip Code: 68198-8102
• Mailing Address - Country: US
• Practice Address - Street 1: EMILE @ 42ND ST
• Practice Address - City: OMAHA
• Practice Address - State: NE
• Practice Address - Zip Code: 68198-1045
• Practice Address - Country: US
• Practice Address - Phone: 402-559-1010
• Is Sole Proprietor?: No
• Enumeration Date: 2010-05-12
• Last Update Date: 2022-09-06

Provider Licenses

State	License ID	Taxonomies
KY	C0815	2085R0202X
NE	28452	2085R0202X, 2085R0202X
TX	Q9953	2085R0202X
TN	54252	2085R0202X, 2085R0202X
HI	MD18037	2085R0202X
KS	04-37871	2085R0202X
CA	A113152	2085R0202X
CO	CDRH.0054753	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NE	100262777-00	Medicaid
NE	100262778-00	Medicaid
WY	1346568565	Medicaid
NE	840597929-13	Medicaid
NE	100262775-00	Medicaid
KS	201115010A	Medicaid
CO	P01499473	Other	RAILROAD MEDICARE- CO
IA	1346568565	Medicaid
CO	P01523171	Other	RAILROAD MEDICARE
MT	1346568565	Medicaid
NE	100257090-00	Medicaid
NE	100262773-00	Medicaid
OK	200588360A	Medicaid
CO	01378091	Medicaid
NE	100262776-00	Medicaid
UT	1346568565	Medicaid
NE	100262774-00	Medicaid
NE	840897126-00	Medicaid
UT	1346568565	Medicaid
CO	412067YGPG	Medicare PIN
CO	P01499473	Other	RAILROAD MEDICARE- CO
NE	100262773-00	Medicaid
CO	01378091	Medicaid
CO	412067YQN9	Medicare PIN
NE	100262774-00	Medicaid
UT	1346568565	Medicaid
NE	100257090-00	Medicaid
KS	KA3249074	Medicare PIN
KS	111257083	Medicare PIN
CO	412067YQ33	Medicare PIN
AZ	025611	Medicaid