Healthcare Provider Details

I. General information

NPI: 1437314796
Provider Name (Legal Business Name): AMBER LYNN BECKENHAUER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMBER LYNN STURZENEGGER DO

II. Dates (important events)

Enumeration Date: 07/25/2008
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 S 19TH ST
BLAIR NE
68008-1907
US

IV. Provider business mailing address

407 S 19TH ST
BLAIR NE
68008-1907
US

V. Phone/Fax

Practice location:
  • Phone: 402-552-3222
  • Fax: 402-552-2172
Mailing address:
  • Phone: 402-533-2223
  • Fax: 531-301-6272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number686
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: