Provider Demographics
NPI:1942239421
Name:WITTER, JO ANNA (MD)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:ANNA
Last Name:WITTER
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 1:358 S 10TH
Mailing Address - Street 2:PO BOX 110
Mailing Address - City:DAVID CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68632-2116
Mailing Address - Country:US
Mailing Address - Phone:402-367-3322
Mailing Address - Fax:402-367-3311
Practice Address - Street 1:358 S 10
Practice Address - Street 2:
Practice Address - City:DAVID CITY
Practice Address - State:NE
Practice Address - Zip Code:68632-2116
Practice Address - Country:US
Practice Address - Phone:402-367-3322
Practice Address - Fax:402-367-3311
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18840207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEE91858Medicare UPIN