Jennelea R. Montanez PA - Medical Physician Assistant in Omaha, Nebraska | ProviderWire

Full Name

Jennelea R Montanez PA

NPI Number

1366535049

NPI Type

Individual Provider

Gender

Female

Enumeration Date

10/02/2006

Specialties

(Taxonomies)

Name

Medical Physician Assistant

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Nebraska

License Number

1192

Contact
Information

Purpose

Mailing

Location

Address

13616 CALIFORNIA ST

13616 CALIFORNIA ST

City

Omaha

Omaha

State

NE

NE

Postal Code

68154-5335

68154-5335

Country

US

US

Telephone Number

(402) 496-0404

(402) 496-0404

Identifiers

Identifier

1192

Identifier State

NE

Identifier Issuer

NE LICENSE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/15/2016

Provider Address

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