Healthcare Provider Details

I. General information

NPI: 1649181108
Provider Name (Legal Business Name): ABIGAIL MARIA BETZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20248 GATEWAY RD
ELKHORN NE
68022-2320
US

IV. Provider business mailing address

20248 GATEWAY RD
ELKHORN NE
68022-2320
US

V. Phone/Fax

Practice location:
  • Phone: 507-840-0994
  • Fax:
Mailing address:
  • Phone: 507-840-0994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM1400X
TaxonomyNurse Massage Therapist (NMT)
License Number90991
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: