Provider Demographics
NPI:1851526891
Name:JANK, JULIE M (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:JANK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 E 14TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3240
Mailing Address - Country:US
Mailing Address - Phone:402-463-2929
Mailing Address - Fax:402-463-2939
Practice Address - Street 1:223 E 14TH ST STE 100
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3240
Practice Address - Country:US
Practice Address - Phone:402-463-2929
Practice Address - Fax:402-463-2939
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE25270207Q00000X
WAML 20009150207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine