Healthcare Provider Details

I. General information

NPI: 1942925334
Provider Name (Legal Business Name): TAYLOR ANN DEAL MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2022
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 N HEALTHY WAY
FREMONT NE
68025-2315
US

IV. Provider business mailing address

825 S 169TH ST
OMAHA NE
68118-9300
US

V. Phone/Fax

Practice location:
  • Phone: 402-941-7850
  • Fax: 402-815-9181
Mailing address:
  • Phone: 402-941-7850
  • Fax: 402-815-9181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.1671325
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number115436
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: