Healthcare Provider Details
I. General information
NPI: 1972616423
Provider Name (Legal Business Name): THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2006
Last Update Date: 09/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
606 N MINNESOTA AVE STE 1
HASTINGS NE
68901-5256
US
IV. Provider business mailing address
715 N SAINT JOSEPH AVE
HASTINGS NE
68901-4451
US
V. Phone/Fax
- Phone: 402-461-5265
- Fax:
- Phone: 402-463-4521
- Fax: 402-461-5321
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ERIC
A.
BARBER
Title or Position: CEO
Credential:
Phone: 402-461-5108