Provider Demographics
NPI:1932094554
Name:KRATOCHVIL, JACOB ZACHARY
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:ZACHARY
Last Name:KRATOCHVIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2768 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-2437
Mailing Address - Country:US
Mailing Address - Phone:402-270-4272
Mailing Address - Fax:
Practice Address - Street 1:2768 31ST AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-2437
Practice Address - Country:US
Practice Address - Phone:402-270-4272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist