Beaty, Jennifer Sam

Beaty, Jennifer Sam is an individual health care provider with primary practice located at 9850 Nicholas St Ste 100 , Omaha NE 68114-2191. She recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as her primary health care specialty. Beaty, Jennifer Sam can be contacted via phone (402) 343-1122.

Contact Information

Primary practice address
9850 Nicholas St Ste 100 Omaha NE 68114-2191
Phone: (402) 343-1122
Fax: (402) 343-1177
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 24105 Nebraska

Profile Details

NPI number 1427094648
LBN Legal business name Beaty, Jennifer Sam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Mar 17th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427094648 NPPES
Iowa MEDICAID 0490938
Iowa MEDICAID 47053395014
Iowa Other CH7569

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