Provider Demographics
NPI:1619971678
Name:DRAPER, JAMIE RENEE (APRN CPNP)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:RENEE
Last Name:DRAPER
Suffix:
Gender:F
Credentials:APRN CPNP
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:RENEE
Other - Last Name:JEFFREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6301 ORCHARD ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-1807
Mailing Address - Country:US
Mailing Address - Phone:402-520-6616
Mailing Address - Fax:
Practice Address - Street 1:6301 ORCHARD ST STE 3
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-1807
Practice Address - Country:US
Practice Address - Phone:402-520-6616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110526363LP0200X, 2080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47079049100Medicaid
NE10026369300Medicaid
NE10025151600Medicaid
NE47079049112Medicaid