Provider Demographics
NPI:1871390146
Name:LENHART, JACK
Entity type:Individual
Prefix:
First Name:JACK
Middle Name:
Last Name:LENHART
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 1:7307 N 279TH ST APT 303
Mailing Address - Street 2:
Mailing Address - City:VALLEY
Mailing Address - State:NE
Mailing Address - Zip Code:68064-8071
Mailing Address - Country:US
Mailing Address - Phone:402-312-2113
Mailing Address - Fax:
Practice Address - Street 1:7307 N 279TH ST APT 303
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:NE
Practice Address - Zip Code:68064-8071
Practice Address - Country:US
Practice Address - Phone:402-312-2113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant