Healthcare Provider Details

I. General information

NPI: 1811515026
Provider Name (Legal Business Name): JAMES K FRUEHLING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 07/14/2020
Certification Date: 07/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W COURT ST
BEATRICE NE
68310-3526
US

IV. Provider business mailing address

PO BOX 187
DAVENPORT NE
68335-0187
US

V. Phone/Fax

Practice location:
  • Phone: 402-223-5277
  • Fax:
Mailing address:
  • Phone: 402-499-4739
  • Fax: 402-223-5277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number329
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: