Provider Demographics
NPI:1134337009
Name:JORGENSEN, AMIE JEANNE (MD)
Entity type:Individual
Prefix:
First Name:AMIE
Middle Name:JEANNE
Last Name:JORGENSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMIE
Other - Middle Name:JEANNE
Other - Last Name:FINKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3340 COTTONMILL AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-0720
Mailing Address - Country:US
Mailing Address - Phone:402-880-5880
Mailing Address - Fax:308-865-2747
Practice Address - Street 1:101 W 24TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-5358
Practice Address - Country:US
Practice Address - Phone:308-865-2740
Practice Address - Fax:308-865-2747
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE25711207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47064617113Medicaid
NE095291Medicare PIN