Healthcare Provider Details

I. General information

NPI: 1831151232
Provider Name (Legal Business Name): ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date: 09/09/2022
Reactivation Date: 10/09/2022

III. Provider practice location address

600 N COTNER BLVD SUITE 208
LINCOLN NE
68505-2343
US

IV. Provider business mailing address

600 N COTNER BLVD
LINCOLN NE
68505-2343
US

V. Phone/Fax

Practice location:
  • Phone: 402-464-5969
  • Fax: 402-464-3657
Mailing address:
  • Phone: 402-464-5969
  • Fax: 402-464-3657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. ASHLEY BEETHE
Title or Position: ADMINISTRATIVE COORDINATOR
Credential:
Phone: 402-464-5969