Provider Demographics
NPI:1639763196
Name:KREUTZ, JAIME JEAN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:JEAN
Last Name:KREUTZ
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W PLUM ST
Mailing Address - Street 2:
Mailing Address - City:DONIPHAN
Mailing Address - State:NE
Mailing Address - Zip Code:68832-9564
Mailing Address - Country:US
Mailing Address - Phone:402-845-2730
Mailing Address - Fax:
Practice Address - Street 1:302 W PLUM ST
Practice Address - Street 2:
Practice Address - City:DONIPHAN
Practice Address - State:NE
Practice Address - Zip Code:68832-9564
Practice Address - Country:US
Practice Address - Phone:402-845-2730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE59711163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool