Provider Demographics
NPI:1578368825
Name:JORGENSEN, JOEL STEVEN
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:STEVEN
Last Name:JORGENSEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 GRAINLAND RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NE
Mailing Address - Zip Code:68787-1648
Mailing Address - Country:US
Mailing Address - Phone:402-369-2836
Mailing Address - Fax:
Practice Address - Street 1:1201 GRAINLAND RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NE
Practice Address - Zip Code:68787-1648
Practice Address - Country:US
Practice Address - Phone:402-369-2836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider