Healthcare Provider Details

I. General information

NPI: 1962610493
Provider Name (Legal Business Name): COMPLETE CHILDREN'S HEALTH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8201 NORTHWOODS DR
LINCOLN NE
68505-3092
US

IV. Provider business mailing address

8201 NORTHWOODS DR
LINCOLN NE
68505-3092
US

V. Phone/Fax

Practice location:
  • Phone: 402-465-5600
  • Fax: 402-327-6074
Mailing address:
  • Phone: 402-465-5600
  • Fax: 402-327-6074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT D JANSEN
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 402-327-6001