Provider Demographics
NPI:1588462139
Name:VALENTA, JENNIFER LEE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:VALENTA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LEE
Other - Last Name:LICKITER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:545 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046
Mailing Address - Country:US
Mailing Address - Phone:531-205-1381
Mailing Address - Fax:
Practice Address - Street 1:1820 HILLCREST DRIVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005
Practice Address - Country:US
Practice Address - Phone:402-682-6599
Practice Address - Fax:402-682-6563
Is Sole Proprietor?:No
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant