Provider Demographics
NPI:1760484356
Name:GENTHE, JENNIFER ANN (APRN, CPNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:GENTHE
Suffix:
Gender:F
Credentials:APRN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 A ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4201
Mailing Address - Country:US
Mailing Address - Phone:402-489-0800
Mailing Address - Fax:408-489-6803
Practice Address - Street 1:7001 A ST
Practice Address - Street 2:SUITE 110
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4201
Practice Address - Country:US
Practice Address - Phone:402-489-0800
Practice Address - Fax:408-489-6803
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2008-03-03
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
NE110715363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics