Provider Demographics
NPI:1942305693
Name:PAKNIKAR, JAYASHREE (MD)
Entity Type:Individual
Prefix:MRS
First Name:JAYASHREE
Middle Name:
Last Name:PAKNIKAR
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 1:7100 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2714
Mailing Address - Country:US
Mailing Address - Phone:402-506-9000
Mailing Address - Fax:402-315-2727
Practice Address - Street 1:7100 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106
Practice Address - Country:US
Practice Address - Phone:402-506-9000
Practice Address - Fax:402-315-2727
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21836207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE278203Medicare ID - Type Unspecified
NEH56752Medicare UPIN
NE10025227400Medicaid