Provider Demographics
NPI:1447068788
Name:AVANT, JENNEFER M
Entity type:Individual
Prefix:
First Name:JENNEFER
Middle Name:M
Last Name:AVANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 MEREDITH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-2336
Mailing Address - Country:US
Mailing Address - Phone:402-490-9280
Mailing Address - Fax:
Practice Address - Street 1:3180 MEREDITH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-2336
Practice Address - Country:US
Practice Address - Phone:402-490-9280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider