Healthcare Provider Details

I. General information

NPI: 1295665495
Provider Name (Legal Business Name): JOEL EDWIN CLOETER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11703 S 54TH ST
BELLEVUE NE
68133-2992
US

IV. Provider business mailing address

11703 S 54TH ST
BELLEVUE NE
68133-2992
US

V. Phone/Fax

Practice location:
  • Phone: 402-763-9140
  • Fax:
Mailing address:
  • Phone: 402-763-9140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: