Provider Demographics
NPI:1528077179
Name:SKRADSKI, JESSICA JO (RPH, PHARMD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:JO
Last Name:SKRADSKI
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:DR
Other - First Name:JESSICA
Other - Middle Name:JO
Other - Last Name:OBERMEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH, PHARMD
Mailing Address - Street 1:10132 EDWARD ST
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-2500
Mailing Address - Country:US
Mailing Address - Phone:402-326-1945
Mailing Address - Fax:402-449-4531
Practice Address - Street 1:601 N 30TH ST
Practice Address - Street 2:SUITE 2807
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2137
Practice Address - Country:US
Practice Address - Phone:402-449-4560
Practice Address - Fax:402-449-4531
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist