NPI 1114574696 · live from the CMS NPI Registry
Jose Bajo
Nurse Practitioner in Grand Island, NE. National Provider Identifier 1114574696, active.
NPI record
| NPI | 1114574696 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 800 N Alpha St, Grand Island, NE 68803 |
| Practice phone | 308-382-2010 |
| Mailing address | 1623 Boyce St, Hastings, NE 68901 |
| Enumerated | August 20, 2019 |
| Last updated | August 20, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner primary | 363L00000X | 000-00-00 (NE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.