Provider Demographics
NPI:1972796944
Name:GRAHAM, JENNIFER CHRISTINE (MPAS)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CHRISTINE
Last Name:GRAHAM
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Gender:F
Credentials:MPAS
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Mailing Address - Street 1:7441 O ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2468
Mailing Address - Country:US
Mailing Address - Phone:402-488-7400
Mailing Address - Fax:402-488-0739
Practice Address - Street 1:7441 O ST
Practice Address - Street 2:SUITE 400
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2468
Practice Address - Country:US
Practice Address - Phone:402-488-7400
Practice Address - Fax:402-488-0739
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2013-02-21
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Provider Licenses
StateLicense IDTaxonomies
NE1330363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant