Provider Demographics
NPI:1730078247
Name:MCCARTHY, JESSICA RENEE (LPN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RENEE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 SUMMIT PLAZA DR
Mailing Address - Street 2:JESS77MCCARTHY@GMAIL.COM
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005
Mailing Address - Country:US
Mailing Address - Phone:531-205-4896
Mailing Address - Fax:
Practice Address - Street 1:3604 SUMMIT PLAZA DR
Practice Address - Street 2:JESS77MCCARTHY@GMAIL.COM
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005
Practice Address - Country:US
Practice Address - Phone:531-205-4896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20607164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse