Provider Demographics
NPI:1609966043
Name:JURGENSEN DUBA NP, JANET R (APRN NP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:R
Last Name:JURGENSEN DUBA NP
Suffix:
Gender:F
Credentials:APRN NP
Other - Prefix:MS
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:DUBA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN NP
Mailing Address - Street 1:908 N HOWARD AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-3529
Mailing Address - Country:US
Mailing Address - Phone:308-675-1931
Mailing Address - Fax:308-675-1934
Practice Address - Street 1:908 N HOWARD AVE
Practice Address - Street 2:STE 102
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3529
Practice Address - Country:US
Practice Address - Phone:308-675-1931
Practice Address - Fax:308-675-1934
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110175363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026009700Medicaid
NE10026009700Medicaid
NE275897Medicare ID - Type Unspecified