Provider Demographics
NPI:1619490380
Name:JESZ, SKYLER KRISTINE (PA-C)
Entity Type:Individual
Prefix:
First Name:SKYLER
Middle Name:KRISTINE
Last Name:JESZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 BELLEVUE MEDICAL CENTER DR STE 145A
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-1556
Mailing Address - Country:US
Mailing Address - Phone:402-779-7207
Mailing Address - Fax:402-779-7210
Practice Address - Street 1:2510 BELLEVUE MEDICAL CENTER DR STE 145A
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123
Practice Address - Country:US
Practice Address - Phone:402-779-7207
Practice Address - Fax:402-779-7210
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2157363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2157OtherSTATE LICENSE