Provider Demographics
NPI:1760700744
Name:BENDER-BRUMMELS, JENNIFER ANN (PLMHP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANN
Last Name:BENDER-BRUMMELS
Suffix:
Gender:F
Credentials:PLMHP
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 PHILLIP AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5248
Mailing Address - Country:US
Mailing Address - Phone:402-371-8000
Mailing Address - Fax:402-371-0971
Practice Address - Street 1:302 W PHILLIP AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701
Practice Address - Country:US
Practice Address - Phone:402-371-8000
Practice Address - Fax:402-371-0971
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9138101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE39189435426Medicaid
NE96115OtherBLUE CROSS BLUE SHIELS