Provider Demographics
NPI:1245026954
Name:BLASZAK, JANNA MARIE
Entity type:Individual
Prefix:
First Name:JANNA
Middle Name:MARIE
Last Name:BLASZAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANNA
Other - Middle Name:MARIE
Other - Last Name:BUTTRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1441 RANCH CIR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3305
Mailing Address - Country:US
Mailing Address - Phone:402-658-6667
Mailing Address - Fax:
Practice Address - Street 1:7500 MERCY RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2319
Practice Address - Country:US
Practice Address - Phone:402-398-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program