Provider Demographics
NPI:1427042225
Name:YAGER, JENNIFER L (OD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:YAGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 N 27TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68503-1802
Mailing Address - Country:US
Mailing Address - Phone:402-476-3311
Mailing Address - Fax:402-476-0157
Practice Address - Street 1:1012 N 27TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68503-1802
Practice Address - Country:US
Practice Address - Phone:402-476-3311
Practice Address - Fax:402-476-0157
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1174152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE274668Medicare ID - Type Unspecified
NEU87061Medicare UPIN