Provider Demographics
NPI:1952333270
Name:NEPPER, MARTHA JEAN (R,D,)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:JEAN
Last Name:NEPPER
Suffix:
Gender:F
Credentials:R,D,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2797
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-2797
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8111 DODGE ST STE 332
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4119
Practice Address - Country:US
Practice Address - Phone:402-354-5947
Practice Address - Fax:402-354-5651
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE257133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE257OtherMEDICAL NUTRITION LICENSE
NE280554Medicare ID - Type Unspecified