Healthcare Provider Details

I. General information

NPI: 1013270982
Provider Name (Legal Business Name): SEAN DAVID PIETRINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2012
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 22ND AVE
KEARNEY NE
68845-2206
US

IV. Provider business mailing address

816 22ND AVE STE 100
KEARNEY NE
68845-2226
US

V. Phone/Fax

Practice location:
  • Phone: 308-455-3600
  • Fax: 308-455-3950
Mailing address:
  • Phone: 308-865-2263
  • Fax: 308-865-2541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number28933
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: