Provider Demographics
NPI:1265746762
Name:BUKREY, JAIME L (MS, CCC, SLP)
Entity type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:L
Last Name:BUKREY
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:MISS
Other - First Name:JAIME
Other - Middle Name:L
Other - Last Name:MUNSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5401 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2150
Mailing Address - Country:US
Mailing Address - Phone:402-483-9534
Mailing Address - Fax:402-486-9098
Practice Address - Street 1:5401 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2150
Practice Address - Country:US
Practice Address - Phone:402-483-9534
Practice Address - Fax:402-486-9098
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1401235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist