Healthcare Provider Details

I. General information

NPI: 1750084091
Provider Name (Legal Business Name): VIRGINIA BARRAGAN-LOPEZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E 23RD ST
FREMONT NE
68025-2303
US

IV. Provider business mailing address

450 E 23RD ST
FREMONT NE
68025-2303
US

V. Phone/Fax

Practice location:
  • Phone: 402-727-3377
  • Fax:
Mailing address:
  • Phone: 402-727-3377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number3152
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: