Provider Demographics
NPI:1477662245
Name:NEWELL, JENNIFER L (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:NEWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 N COTNER BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2310
Mailing Address - Country:US
Mailing Address - Phone:402-441-3400
Mailing Address - Fax:402-441-3430
Practice Address - Street 1:770 N COTNER BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2310
Practice Address - Country:US
Practice Address - Phone:402-441-3400
Practice Address - Fax:402-441-3430
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE21411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE07259OtherBCBS OF NE
0402207OtherUNITED HEALTHCARE
278929Medicare ID - Type Unspecified
NE07259OtherBCBS OF NE
P00222570Medicare ID - Type UnspecifiedRAILROAD MEDICARE