Most Relevant Information
Provider Data
| NPI Number: | 1003223314 |
| Provider Name: | JENNA SULLIVAN CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 68437 |
Most Important Dates
| Enumeration Date: | 07/18/2014 |
| Last Updated: | 10/20/2022 |
Provider Practice Location
7500 MERCY ROAD
OMAHA
NE
681242319
Practice Location Phone/Fax
| Phone: | 4023986060 |
| Fax: |
Provider Mailing Location
7500 MERCY ROAD
OMAHA
NE
681242319
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |