Jonathan L Pedersen
Chore Provider in Sutton, NE. Individual provider (NPI-1).
NPI number1093690760
StatusActive
Last updated in NPPESAug 11, 2025
Details
- NPI
- 1093690760
- Entity type
- Individual (NPI-1)
- Name
- Jonathan L Pedersen
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 11, 2025
- Certification date
- Aug 11, 2025
- Last updated
- Aug 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 372500000X | Chore Provider | – | – | Yes |
Practice location
301 N Euclid AveSutton, NE 68979-2441
Phone 402-762-5045
Mailing address
301 N Euclid AveSutton, NE 68979-2441
Phone 402-762-5045
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