Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1100 | NE |
NPI | 1003923855 |
---|---|
Provider Name | Jennifer Lynn Brammeier |
First Address | Omaha, NE 68135 |
Second Address | Omaha, NE 68137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 19/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U71413 | (02) |