Provider Demographics
NPI:1679953475
Name:SMITH, JENNIFER R (APRN NP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN NP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:R
Other - Last Name:BAER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:1605 10TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-2409
Mailing Address - Country:US
Mailing Address - Phone:308-633-6010
Mailing Address - Fax:308-633-6011
Practice Address - Street 1:1605 10TH ST STE B
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-2409
Practice Address - Country:US
Practice Address - Phone:308-633-6010
Practice Address - Fax:308-633-6011
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111806363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care