Provider Demographics
NPI:1679259709
Name:HERMAN, JESSICA S (RN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:S
Last Name:HERMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-2292
Mailing Address - Country:US
Mailing Address - Phone:402-826-5855
Mailing Address - Fax:
Practice Address - Street 1:1500 E 15TH ST
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:NE
Practice Address - Zip Code:68333-1936
Practice Address - Country:US
Practice Address - Phone:402-826-5844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE76437163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool