Provider Demographics
NPI:1336384536
Name:MUSGRAVE, JENNIFER JULIA (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JULIA
Last Name:MUSGRAVE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:JULIA
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:301 S 70TH ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2469
Mailing Address - Country:US
Mailing Address - Phone:402-488-2225
Mailing Address - Fax:
Practice Address - Street 1:301 S 70TH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2469
Practice Address - Country:US
Practice Address - Phone:402-488-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1418111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor