Provider Demographics
NPI:1053117895
Name:BRONSON, JAN MARIE
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:MARIE
Last Name:BRONSON
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 1:511 N OSBORN AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68045-1122
Mailing Address - Country:US
Mailing Address - Phone:402-720-4103
Mailing Address - Fax:
Practice Address - Street 1:511 N OSBORN AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NE
Practice Address - Zip Code:68045-1122
Practice Address - Country:US
Practice Address - Phone:402-720-4561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide