Provider Demographics
NPI:1588806590
Name:JENNIFER H. CYR, MD. PC
Entity Type:Organization
Organization Name:JENNIFER H. CYR, MD. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING, CREDENTIALING
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:H
Authorized Official - Last Name:HORSEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-709-0063
Mailing Address - Street 1:820 S 75TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4623
Mailing Address - Country:US
Mailing Address - Phone:402-391-2477
Mailing Address - Fax:402-397-4268
Practice Address - Street 1:820 S 75TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4623
Practice Address - Country:US
Practice Address - Phone:402-391-2477
Practice Address - Fax:402-397-4268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE175552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025729800Medicaid