Provider Demographics
NPI:1316835168
Name:EVERETT, JEFFREY PAUL
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:PAUL
Last Name:EVERETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 DOYLE DR
Mailing Address - Street 2:
Mailing Address - City:BOYS TOWN
Mailing Address - State:NE
Mailing Address - Zip Code:68010-7528
Mailing Address - Country:US
Mailing Address - Phone:402-880-5238
Mailing Address - Fax:
Practice Address - Street 1:350 DOYLE DR
Practice Address - Street 2:
Practice Address - City:BOYS TOWN
Practice Address - State:NE
Practice Address - Zip Code:68010-7528
Practice Address - Country:US
Practice Address - Phone:402-880-5238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant