Healthcare Provider Details

I. General information

NPI: 1033022843
Provider Name (Legal Business Name): BLUESTEM HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 O ST STE S111
LINCOLN NE
68510-2647
US

IV. Provider business mailing address

8101 O ST STE S111
LINCOLN NE
68510-2647
US

V. Phone/Fax

Practice location:
  • Phone: 402-476-1455
  • Fax: 402-476-1670
Mailing address:
  • Phone: 402-476-1455
  • Fax: 402-476-1670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: AMY EMERY
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 402-817-3290