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NPI Code Detail

MEDICARE: DR. MARTHA ELIZABETH NUNN D.D.S.

MEDICARE: DR. MARTHA ELIZABETH NUNN D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDS4613TN
21223G0001XGeneral Practice DentistryDENTAL FACULTY 116NE
3122300000XDentist7805NE

General Provider Information

NPI Number : 1013219062
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARTHA ELIZABETH NUNN D.D.S.
Provider Business Mailing Address
First Line : 4321 41ST AVE
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-2131
Country : US
Telephone Number : 402-562-7500
Fax Number : 402-564-0611
Provider Business Practice Location Address
First Line : 4321 41ST AVE
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-2131
Country : US
Telephone Number : 402-562-7500
Fax Number : 402-564-0611
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2010
Last Update Date : 10/26/2022

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