Healthcare Provider Details

I. General information

NPI: 1376454561
Provider Name (Legal Business Name): TATE PFEIFER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3909 TWIN CREEK DR STE 105
BELLEVUE NE
68123-4179
US

IV. Provider business mailing address

904 TILDEN AVE
HASTINGS NE
68901-3561
US

V. Phone/Fax

Practice location:
  • Phone: 402-991-8959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3173
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: