Healthcare Provider Details

I. General information

NPI: 1891659793
Provider Name (Legal Business Name): HALLEE ELAINE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HALLEE ELAINE MANN

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 MEMORIAL DR
BROKEN BOW NE
68822-1378
US

IV. Provider business mailing address

211 N 20TH ST
ORD NE
68862-1318
US

V. Phone/Fax

Practice location:
  • Phone: 308-872-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: